Geographical Patterns of HIV Sero-Discordancy in High HIV Prevalence Countries in Sub-Saharan Africa
<p dir="ltr">Introduction: Variation in the proportion of individuals living in a stable HIV sero-discordant partnership (SDP), and the potential drivers of such variability across sub Saharan Africa (SSA), are still not well-understood. This study aimed to examine the spatial cluste...
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2016
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| _version_ | 1864513556437794816 |
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| author | Diego Cuadros (5506385) |
| author2 | Laith Abu-Raddad (316350) |
| author2_role | author |
| author_facet | Diego Cuadros (5506385) Laith Abu-Raddad (316350) |
| author_role | author |
| dc.creator.none.fl_str_mv | Diego Cuadros (5506385) Laith Abu-Raddad (316350) |
| dc.date.none.fl_str_mv | 2016-08-31T03:00:00Z |
| dc.identifier.none.fl_str_mv | 10.3390/ijerph13090865 |
| dc.relation.none.fl_str_mv | https://figshare.com/articles/journal_contribution/Geographical_Patterns_of_HIV_Sero-Discordancy_in_High_HIV_Prevalence_Countries_in_Sub-Saharan_Africa/27101602 |
| dc.rights.none.fl_str_mv | CC BY 4.0 info:eu-repo/semantics/openAccess |
| dc.subject.none.fl_str_mv | Health sciences Epidemiology Public health HIV serodiscordancy geographical clustering sub Saharan Africa |
| dc.title.none.fl_str_mv | Geographical Patterns of HIV Sero-Discordancy in High HIV Prevalence Countries in Sub-Saharan Africa |
| dc.type.none.fl_str_mv | Text Journal contribution info:eu-repo/semantics/publishedVersion text contribution to journal |
| description | <p dir="ltr">Introduction: Variation in the proportion of individuals living in a stable HIV sero-discordant partnership (SDP), and the potential drivers of such variability across sub Saharan Africa (SSA), are still not well-understood. This study aimed to examine the spatial clustering of HIV sero-discordancy, and the impact of local variation in HIV prevalence on patterns of sero-discordancy in high HIV prevalence countries in SSA. Methods: We described the spatial patterns of sero-discordancy among stable couples by analyzing Demographic and Health Survey data from Cameroon, Kenya, Lesotho, Tanzania, Malawi, Zambia, and Zimbabwe. We identified spatial clusters of SDPs in each country through a Kulldorff spatial scan statistics analysis. After a geographical cluster was identified, epidemiologic measures of sero-discordancy were calculated and analyzed. Results: Spatial clusters with significantly high numbers of SDPs were identified and characterized in Kenya, Malawi, and Tanzania, and they largely overlapped with the clusters with high HIV prevalence. There was a positive correlation between HIV prevalence and the proportion of SDPs among all stable couples across within and outside clusters. Conversely, there was a negative, but weak and not significant, correlation between HIV prevalence and the proportion of SDPs among all stable couples with at least one HIV-infected individual in the partnership. Discussion: There does not appear to be distinct spatial patterns for HIV sero-discordancy that are independent of HIV prevalence patterns. The variation of the sero-discordancy measures with HIV prevalence across clusters and outside clusters demonstrated similar patterns to those observed at the national level. The spatial variable does not appear to be a fundamental nor independent determinant of the observed patterns of sero-discordancy in high HIV prevalence countries in SSA.</p><h2>Other Information</h2><p dir="ltr">Published in: International Journal of Environmental Research and Public Health<br>License: <a href="https://creativecommons.org/licenses/by/4.0/" target="_blank">https://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.3390/ijerph13090865" target="_blank">https://dx.doi.org/10.3390/ijerph13090865</a></p> |
| eu_rights_str_mv | openAccess |
| id | Manara2_a6a7c06d238d2f8e82af889eba6459c1 |
| identifier_str_mv | 10.3390/ijerph13090865 |
| network_acronym_str | Manara2 |
| network_name_str | Manara2 |
| oai_identifier_str | oai:figshare.com:article/27101602 |
| publishDate | 2016 |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| rights_invalid_str_mv | CC BY 4.0 |
| spelling | Geographical Patterns of HIV Sero-Discordancy in High HIV Prevalence Countries in Sub-Saharan AfricaDiego Cuadros (5506385)Laith Abu-Raddad (316350)Health sciencesEpidemiologyPublic healthHIVserodiscordancygeographical clusteringsub Saharan Africa<p dir="ltr">Introduction: Variation in the proportion of individuals living in a stable HIV sero-discordant partnership (SDP), and the potential drivers of such variability across sub Saharan Africa (SSA), are still not well-understood. This study aimed to examine the spatial clustering of HIV sero-discordancy, and the impact of local variation in HIV prevalence on patterns of sero-discordancy in high HIV prevalence countries in SSA. Methods: We described the spatial patterns of sero-discordancy among stable couples by analyzing Demographic and Health Survey data from Cameroon, Kenya, Lesotho, Tanzania, Malawi, Zambia, and Zimbabwe. We identified spatial clusters of SDPs in each country through a Kulldorff spatial scan statistics analysis. After a geographical cluster was identified, epidemiologic measures of sero-discordancy were calculated and analyzed. Results: Spatial clusters with significantly high numbers of SDPs were identified and characterized in Kenya, Malawi, and Tanzania, and they largely overlapped with the clusters with high HIV prevalence. There was a positive correlation between HIV prevalence and the proportion of SDPs among all stable couples across within and outside clusters. Conversely, there was a negative, but weak and not significant, correlation between HIV prevalence and the proportion of SDPs among all stable couples with at least one HIV-infected individual in the partnership. Discussion: There does not appear to be distinct spatial patterns for HIV sero-discordancy that are independent of HIV prevalence patterns. The variation of the sero-discordancy measures with HIV prevalence across clusters and outside clusters demonstrated similar patterns to those observed at the national level. The spatial variable does not appear to be a fundamental nor independent determinant of the observed patterns of sero-discordancy in high HIV prevalence countries in SSA.</p><h2>Other Information</h2><p dir="ltr">Published in: International Journal of Environmental Research and Public Health<br>License: <a href="https://creativecommons.org/licenses/by/4.0/" target="_blank">https://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.3390/ijerph13090865" target="_blank">https://dx.doi.org/10.3390/ijerph13090865</a></p>2016-08-31T03:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.3390/ijerph13090865https://figshare.com/articles/journal_contribution/Geographical_Patterns_of_HIV_Sero-Discordancy_in_High_HIV_Prevalence_Countries_in_Sub-Saharan_Africa/27101602CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/271016022016-08-31T03:00:00Z |
| spellingShingle | Geographical Patterns of HIV Sero-Discordancy in High HIV Prevalence Countries in Sub-Saharan Africa Diego Cuadros (5506385) Health sciences Epidemiology Public health HIV serodiscordancy geographical clustering sub Saharan Africa |
| status_str | publishedVersion |
| title | Geographical Patterns of HIV Sero-Discordancy in High HIV Prevalence Countries in Sub-Saharan Africa |
| title_full | Geographical Patterns of HIV Sero-Discordancy in High HIV Prevalence Countries in Sub-Saharan Africa |
| title_fullStr | Geographical Patterns of HIV Sero-Discordancy in High HIV Prevalence Countries in Sub-Saharan Africa |
| title_full_unstemmed | Geographical Patterns of HIV Sero-Discordancy in High HIV Prevalence Countries in Sub-Saharan Africa |
| title_short | Geographical Patterns of HIV Sero-Discordancy in High HIV Prevalence Countries in Sub-Saharan Africa |
| title_sort | Geographical Patterns of HIV Sero-Discordancy in High HIV Prevalence Countries in Sub-Saharan Africa |
| topic | Health sciences Epidemiology Public health HIV serodiscordancy geographical clustering sub Saharan Africa |