Spatial distribution and determinants of HIV prevalence among adults in urban Ethiopia: Findings from the Ethiopia Population-based HIV Impact Assessment Survey (2017–2018)

Gelibo, Terefe; Lulseged, Sileshi; Eshetu, Frehywot; Abdella, Saro; Melaku, Zenebe; Ajiboye, Solape; Demissie, Minilik; Solmo, Chelsea; Ahmed, Jelaludin; Getaneh, Yimam; Kaydos-Daniels, S. Cornelia; Abate, Ebba

doi:10.1371/journal.pone.0271221

Cited by 11 publications

(8 citation statements)

References 36 publications

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“…Several studies conducted in Ethiopia [ 11 , 12 , 14 , 15 , 16 , 18 ] and in other countries, including Nigeria [ 22 , 23 ], China [ 21 ], and South Africa [ 24 ], revealed a strong tendency toward the spatial clustering of TB at different geographic scales. Similarly, a number of studies showed the spatial clustering of HIV at different scales [ 19 , 25 , 26 , 27 ].…”

Section: Discussionmentioning

confidence: 99%

“…The spatial analysis of a disease helps to understand the spatial epidemiology of the disease occurrence (incidence) at different administrative levels [ 10 ]. There are several studies in Ethiopia that have investigated the spatial clustering of TB and HIV separately at various levels [ 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 ]. Studies in other countries also reported spatial clustering of tuberculosis, e.g., in Brazil [ 20 ], China [ 21 ], Nigeria [ 22 , 23 ] and in South Africa [ 24 ].…”

Section: Introductionmentioning

confidence: 99%

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Spatial Co-Clustering of Tuberculosis and HIV in Ethiopia

Gemechu

Debusho

2022

Diseases

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Background: Tuberculosis (TB) and HIV are epidemiologically associated, and their co-dynamics suggest that the two diseases are directly related at the population level and within the host. However, there is no or little information on the joint spatial patterns of the two diseases in Ethiopia. The main objective of the current study was to assess the spatial co-clustering of TB and HIV cases simultaneously in Ethiopia at the district level. Methods: District-level aggregated data collected from the national Health Management Information System (HMIS) for the years 2015 to 2018 on the number of TB cases enrolled in directly observed therapy, short course (DOTS) who were tested for HIV and the number of HIV patients enrolled in HIV care who were screened for TB during their last visit to health care facilities were used in this study. The univariate and bivariate global and local Moran’s I indices were applied to assess the spatial clustering of TB and HIV separately and jointly. Results: The results of this study show that the two diseases were significantly (p-value <0.001) spatially autocorrelated at the district level with minimum and maximum global Moran’s I values of 0.407 and 0.432 for TB, 0.102 and 0.247 for HIV, and 0.152 and 0.251 for joint TB/HIV. The district-level TB/HIV spatial co-clustering patterns in Ethiopia in most cases overlapped with the hot spots of TB and HIV. The TB/HIV hot-spot clusters may appear due to the observed high TB and HIV prevalence rates in the hot-spot districts. Our results also show that there were low-low TB/HIV co-clusters or cold spots in most of the Afar and Somali regions, which consistently appeared for the period 2015–2018. This may be due to very low notifications of both diseases in the regions. Conclusions: This study expanded knowledge about TB and HIV co-clustering in Ethiopia at the district level. The findings provide information to health policymakers in the country to plan geographically targeted and integrated interventions to jointly control TB and HIV.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Spatial Co-Clustering of Tuberculosis and HIV in Ethiopia

Gemechu

Debusho

2022

Diseases

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“…More importantly, in the current study, widowhood was related to a higher likelihood of positive HIV-RDT, especially in men. Along with this, widowers (male widows) in Ethiopia and Zimbabwe are reported as the population with high HIV prevalence since they may engage in hazardous sexual activities with a high rate of partner change (23,24).…”

Section: Discussionmentioning

confidence: 99%

Assessing Secular Trends in HIV Rapid Diagnostic Test Uptake and Positivity in Northeast Iran, a country in MENA region, and Recommending Gender-Specific Health Policies to Improve.

Yousefli

Maharlouei

Moghaddam

et al. 2022

Preprint

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Background Iran is among the first three countries in MENA region where two-thirds of new HIV infections are reported. The HIV rapid diagnostic testing (HIV-RDT) program, established for early detection of HIV infection, is evaluated in Mashhad, a metropolitan area, and 14 cities in Khorasan-Razavi Province, Iran. Methods In this cross-sectional study, de-identified records of HIV-RDT clients between 2017 and 2021 were extracted from the electronic health information system of 122 testing sites. Descriptive, bivariate and multivariate logistic regression analyses were performed to identify the factors associated with HIV-RDT uptake and risks and drivers of HIV-RDT positivity. Results Conducting 66546 HIV-RDTs among clients with a mean age of 30.31 years, 63% female, 75.2% married, and 78.5% diploma or below, yielded 312 (0.47%) positive results. Prenatal care and suspicious heterosexual intercourse were the most frequent reasons for taking HIV-RDT among women and men, respectively (76% and 61.2%). Test uptake was relatively low among men and the unmarried population. Male gender (odd ratio (OR) = 9.5), higher age at the time of testing (OR = 1.03), widowhood (OR = 3.98), education levels of high school diploma or below (OR = 2.35), and unemployment status (OR = 2.91) were significant sociodemographic predictors of positive HIV-RDT (P-value < 0.05). Furthermore, gender-stratified multivariate analyses revealed unsanitary dental procedures (OR = 15.7), mother-to-child transmission (MTCT)(OR = 29.95), drug injection (OR = 8.21), and male homosexuality (OR = 19.38) as behavioral predictors of test positivity among males (P-value < 0.05). Whilst substance abuse (not only injection) (OR = 12.15), MTCT (OR = 13.54), and being an occupational trainee (OR = 15.08) were predictors among females (P-value < 0.05). Conclusion The study provides significant targets to implement innovative strategies to increase test uptake and yield in the region, and also suggests gender-specific strategies, according to the sociodemographic and behavioral risks, for HIV primary prevention and early detection.

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“…However, the long-term trends and spatial distribution of HIV/AIDS prevalence among older adults in Eastern China have not been adequately assessed. The design and evaluation of national HIV/AIDS planning often rely on comprehensive national data, which can mask local HIV/AIDS epidemics [ 10 ]. To better control the HIV/AIDS epidemic, a more comprehensive and detailed analysis of HIV/AIDS among older adults in Eastern China is needed.…”

Section: Introductionmentioning

confidence: 99%

Spatiotemporal Pattern and Its Determinants for Newly Reported HIV/AIDS Among Older Adults in Eastern China From 2004 to 2021: Retrospective Analysis Study

Huang,

Cheng,

et al. 2024

JMIR Public Health Surveill

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Background In recent years, the number and proportion of newly reported HIV/AIDS cases among older adults have increased dramatically. However, research on the pattern of temporal and spatial changes in newly reported HIV/AIDS among older adults remains limited. Objective This study analyzed the spatial and temporal distribution of HIV/AIDS cases and its influencing factors among older adults in Eastern China from 2004 to 2021, with the goal of improving HIV/AIDS prevention and intervention. Methods We extracted data on newly reported HIV/AIDS cases between 2004 and 2021 from a case-reporting system and used a Joinpoint regression model and an age-period-cohort model to analyze the temporal trends in HIV/AIDS prevalence. Spatial autocorrelation and geographically weighted regression models were used for spatial aggregation and influence factor analysis. Results A total of 12,376 participants with HIV/AIDS were included in the study. The newly reported HIV infections among older adults increased from 0.13 cases per 100,000 people in 2004 to 7.00 cases per 100,000 people in 2021. The average annual percent change in newly reported HIV infections was 28.0% (95% CI –21.6% to 34.8%). The results of the age-period-cohort model showed that age, period, and cohort factors affected the newly reported HIV infections among older adults. The newly reported HIV/AIDS cases among men who have sex with men (MSM) had spatial clustering, and the hotspots were mainly concentrated in Hangzhou. The disposable income of urban residents, illiteracy rate among people aged 15 years or older, and number of hospital beds per 1000 residents showed a positive association with the newly reported HIV infections among older MSM in the Zhejiang province. Conclusions HIV/AIDS among older adults showed an increasing trend and was influenced by age, period, and cohort effects. Older MSM with HIV/AIDS showed regional clustering and was associated with factors such as the disposable income of urban residents, the illiteracy rate among people aged 15 years or older, and the number of hospital beds per 1000 people. Targeted prevention and control measures are needed to reduce HIV infection among those at higher risk.

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Spatial distribution and determinants of HIV prevalence among adults in urban Ethiopia: Findings from the Ethiopia Population-based HIV Impact Assessment Survey (2017–2018)

Cited by 11 publications

References 36 publications

Spatial Co-Clustering of Tuberculosis and HIV in Ethiopia

Spatial Co-Clustering of Tuberculosis and HIV in Ethiopia

Assessing Secular Trends in HIV Rapid Diagnostic Test Uptake and Positivity in Northeast Iran, a country in MENA region, and Recommending Gender-Specific Health Policies to Improve.

Spatiotemporal Pattern and Its Determinants for Newly Reported HIV/AIDS Among Older Adults in Eastern China From 2004 to 2021: Retrospective Analysis Study

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