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

HIV and AIDS in the state of Paraná, Brazil, 2007-2022: trends and spatiotemporal distribution

OBJECTIVE

The aim of this study was to analyze the spatiotemporal evolution of the incidence rates of human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) in the state of Paraná, Brazil.

METHODS

An ecological study with an analytical component of time series analysis was conducted in the state of Paraná from 2007 to 2022. The data source was the Notifiable Diseases Information System. To study the trend, the Prais-Winsten generalized linear regression model was used by decomposing the time series, and for spatial analysis, the Moran's index was applied.

RESULTS

The total sample consisted of 50,676 HIV/AIDS records. The incidence rate showed an increasing trend, with an average growth of 2.14% [95% confidence interval - 95%CI 1.16-3.13] per month. From 2007 to 2014 and from 2015 to 2022, the average number of cases in the state was 105.64 and 159.20 per 100,000 inhabitants, respectively, with significant variation among municipalities. Spatial clusters of high risk persisted in the metropolitan region, the capital, and coastal areas, and a new cluster was observed in the northern region of the state.

CONCLUSION

The incidence rates of HIV/AIDS showed an upward trend over time. The number of cases varied considerably in some municipalities, especially in the coastal region. Spatial analysis revealed geospatial patterns of high risk in the main metropolitan areas of Paraná: Curitiba (including the coastal area), Londrina, and Maringá, which share characteristics such as a high degree of urbanization and ongoing economic development.

Spatial mapping and predictors of ever-tested for HIV in adolescent girls and young women in Ethiopia

Background

Adolescent girls and young women (AGYW) are expected to be healthy in life. However, the unique health challenges faced by AGYW include unsafe sex practices and substance abuse. Only 46.3% of AGYW in Africa are aware of their HIV status, and difficulties are underlined in HIV testing among adolescents and young people. To demarcate the areas with low and high HIV testing, this study aimed to map predictors of ever-tested for HIV among adolescent girls and young women in Ethiopia.

Methods

Secondary data analysis was conducted using the dataset from the 2016 Ethiopia Demographic and Health Survey (EHDS). We conducted spatial autocorrelation and Moran's I statistics to investigate the regional variance of HIV being ever-tested in AGYW. In addition, spatial regression analyses such as ordinary least squares (OLS) regression and geographically weighted regression (GWR) were carried out to determine the predictors of being ever-tested for HIV among AGYW.

Results

Addis Ababa, some parts of Amhara, Dire Dawa, Gambela, and Tigray were the primary regions and city administrations for being ever-tested for HIV among AGYW. A lesser proportion of AGYW being ever-tested for HIV was found in Somalia, Afar, Benshangul Gumuz, and southern nations. Spatial regression analyses identified an age range of 15-19 years, being Muslim, having no formal education, having no knowledge about HIV, and experiencing severe stigma as predictors of being ever-tested for HIV among AGYW.

Conclusion

The proportion of AGYW being ever-tested for HIV was high in Addis Ababa, some parts of Amhara, Dire Dawa, Gambela, and Tigray. Spatial regression analyses identified that AGYW aged 15-19 years, having no formal education, having no knowledge about HIV, and experiencing severe community stigma as predictors negatively affecting the proportion of being ever-tested for HIV, while being Muslim was a predictor that positively affected the proportion of being ever-tested for HIV. The governments and other stakeholders should focus on increasing HIV testing among these special groups of the population.

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

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.

Process evaluation of the 90-90-90 targets of surge project in Addis Ababa, Ethiopia: a case study evaluation

BACKGROUND

Human Immunodeficiency Virus (HIV) is a major public health problem that continues to pose an enormous challenge to mankind's survival worldwide. In urban Ethiopia, the HIV prevalence among adults aged 15-49 years is 2.9%, while in Addis Ababa, it is 3.4%. To take the edge off, the Ethiopian government has been implementing the 90-90-90 strategy also known as the surge project, in urban cities. However, the implementation of the program has not been evaluated. Thus, we evaluated the process of the 90-90-90 targets of the surge project in Addis Ababa, Ethiopia.

METHODS

We conducted a case study with concurrent mixed-methods evaluation. We used indicator-driven evaluation dimensions -availability and accommodation dimensions from the health services access and compliance and fidelity from implementation fidelity frameworks to test the program process theory with a total of 52 indicators. We interviewed a total of 419 clients and 210 healthcare providers and reviewed 417 clients' cards and 17 registries. We also conducted 30 key informant interviews and resource inventory. A binary logistic regression analysis was done to identify factors associated with clients' satisfaction. We transcribed and translated the qualitative data and analysed thematically. Finally, we judged the overall process of the surge project based on the pre-seated judgmental criteria as; needs urgent improvement, needs improvement and well implemented.

RESULTS

We found that 90% of the project process was as per the program process theory measured by the availability of resources (95.8%), compliance (88.0%), fidelity (84.7%), and accommodation of services (89.3%). We found a shortage of human power, test kits, and viral load testing machines. The commitment of health care providers, provider-client interaction, and clients' satisfaction with the service at card rooms were found to be poor. Moreover, being aged 15-24, being married and government government-employed were negatively associated with clients' satisfaction with antiretroviral therapy services.

CONCLUSION

The process of the surge project needs improvement. Moreover, the achievements of the first two 90-90 targets were poor. Therefore, implementers need to take intensified action for the availability of resources and to improve the commitment of healthcare providers through refreshment training.

Uptake of human papillomavirus vaccination and its associated factors among adolescents in Gambella town, Southwest, Ethiopia: a community-based cross-sectional study

OBJECTIVE

To assess the uptake of human papillomavirus (HPV) vaccination and its associated factors among adolescents in Gambella town, Southwest Ethiopia.

DESIGN

A community-based cross-sectional study.

SETTING

Gambella town, Southwest Ethiopia.

PARTICIPANTS

A total of 882 adolescents were included between May and July 2022.

OUTCOME

Uptake of HPV vaccination.

METHODS

A cluster sampling technique was used to select study participants. An interviewer-administered and pretested questionnaire was used to collect the data. The collected data were entered into Epi-data V.4.6 and exported to STATA V.16 for cleaning, coding and analysis. A binary logistic regression model was used to test the association between independent and dependent variables. Variables with a p<0.05 in the multivariable logistic regression were considered statistically significant factors for the uptake of HPV vaccination.

RESULTS

A total of 825 adolescents participated in this study. Among participants, 48% (95% CI 44.6% to 51.4%) have been vaccinated for HPV. Ever heard of the HPV vaccine (AOR 2.5, 95% CI 1.23 to 5.08), good knowledge of HPV infection (AOR 3.62, 95% CI 2.17 to 6.02), good knowledge of the HPV vaccine (AOR 5.54, 95% CI 3.28 to 9.36) and attitude towards the HPV vaccine (AOR 2.74, 95% CI 1.88 to 3.98) were significantly associated HPV vaccination.

CONCLUSION

In the current study, the uptake of HPV vaccination was found to be low. The finding highlights the importance of promoting community health education about HPV infection and vaccines and providing behaviour change education, which plays a substantial role in promoting the uptake of HPV vaccination.

HIV sero-status of healthcare workers in Addis Ababa public hospitals post exposure to infected blood and body fluids: A cross-sectional study, October 2022

The study investigated the sero-status of human immunodeficiency virus among healthcare workers in Addis Ababa public hospitals. A multi-centered, institutional-based, cross-sectional study was conducted from 18 September 2022 to 30 October 2022. A simple random sampling method and a semi-structured, self-administered questionnaire were used to collect the data, which were analyzed using the Statistical Package for Social Sciences (SPSS) version 25. A binary logistic regression model was used to identify the factors associated with the human immunodeficiency virus sero-status of healthcare workers post exposure to infected blood and body fluids. Of the 420 study participants who were exposed to blood and body fluids, 403 (96%) were non-reactive. Healthcare workers who had 20-29 years of work experience had approximately six times higher odds of testing positive for the human immunodeficiency virus (AOR = 6.21, 95% CI: 2.39, 9.55). Healthcare workers who did not use personal protective equipment properly had five times higher odds of testing positive for the human immunodeficiency virus (AOR = 5.02, CI: 3.73, 9.51). This study showed that, among those healthcare workers who tested positive for the human immunodeficiency virus infection, the majority were from the emergency department. Healthcare workers who did not use personal protective equipment properly had higher odds of testing positive for the human immunodeficiency virus.

Spatial Co-Clustering of Tuberculosis and HIV in Ethiopia

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.