Why does a disease flourish in one place and not another? Why does it affect one demographic more than another? Medical geographers grapple with these deceptively simple questions. CCSU Professor of geography and medical geographer Cynthia Pope studies what influences the rate of HIV infection in Belize and Cuba. Belize has a relatively high HIV rate, with 1.4% of the population infected. Cuba has one of the world’s lowest rates at 0.1%. In particular, Dr. Pope focuses on what affects the HIV rate in women.
Dr. Pope became interested in medical geography while studying geography at the University of Arizona. “I fell in love with the topic. I didn’t realize how interested I was in health and medicine at the time,” she said. Medical geographers play an essential part in fighting infectious disease. Their research helps determine what programs and facilities are needed to promote better health within a population. Dr. Pope originally started studying healthcare along the US-Mexico border, which ended up being a good fit. “I lived in Venezuela after high school and my undergraduate degree was in Latin American Studies,” she explained.
In graduate school, Dr. Pope had the chance to do field research in Cuba. “It is an interesting place to research. They have very good healthcare at the primary level. They have a good vaccination rate, nearly 100%. Gender equity is written into the constitution, so a lot of debates we have in the US don’t happen there, especially about women’s health concerns. And they have one of the lowest HIV rates in the world.”
Cuba was the first country in the world that was able to trace HIV infection back to “Patient Zero” – the first person to bring the virus into Cuba. “It was a male Cuban soldier who went to Angola and slept with prostitutes. Then he came back to Havana and infected his wife,” said Dr. Pope.
Dr. Pope is planning to do further research in Cuba within the next few months. “Since [President] Obama opened up some travel it is the perfect time to do Cuba research,” she said. “I mostly work with women in Cuba with HIV. When I first went down in the mid-90s, that was the group getting it more quickly than you’d expect.” This time Dr. Pope will be researching the rise of private healthcare clinics in Cuba and how that may affect the future of Cuban health.
Currently, HIV in Cuba is mostly consigned to men who have sex with men. Unlike some other nations in the region, Cuba has been mostly successful at keeping HIV from proliferating among sex workers, which has tempered the spread of the disease. The rate is also kept down by the almost nonexistence of intravenous drug use in Cuba. Geographically, Cuba gets a boost because it is an urbanized country and relatively wealthy. Medical geographers have found that populations that are poor and rural are at a greater risk for HIV infection. “Cuba was a middle class country before the revolution. Even though there was poverty, there was wealth there,” explained Dr. Pope.
In contrast, Belize has not been as fortunate. The country is roughly the size of Massachusetts and has a population of only 310,000. The population is overwhelmingly rural and poor. Due to this, Belize still struggles with infectious disease of all sorts. Some of the most common causes of death in Belize include influenza and tuberculosis. AIDS is the most common cause of death of those aged 15-49 in the country.
Dr. Pope is currently researching the effects of alcohol and drug consumption on the likelihood of HIV infection among women. Her research will help better define what factors put Belizean women at risk for HIV. She also plans to use GIS (Geographic Information Systems) mapping to better understand the geographical distribution of HIV cases. This combined with her continued work in Cuba will help reveal how healthcare systems, gender roles, and wealth can affect HIV infection. Ultimately, her findings will help public health professionals implement changes that prevent further infections and save lives.