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Kitaw TA, Abate BB, Tilahun BD, Haile RN. Geospatial pattern of HIV seropositivity and its predictors among women in Ethiopia. A spatial and multiscale geographically weighted regression analysis. PLoS One 2024; 19:e0306645. [PMID: 38990932 PMCID: PMC11239007 DOI: 10.1371/journal.pone.0306645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Accepted: 06/20/2024] [Indexed: 07/13/2024] Open
Abstract
BACKGROUND Although promising efforts have been made so far, HIV remains a public health concern. Women in Ethiopia are disproportionately affected by HIV, accounting for a majority of new infections and AIDS-related deaths. However, the geospatial distribution of HIV among women in Ethiopia is not well understood, making it challenging to develop geographically targeted measures. Besides, to accelerate the pathway of decreasing HIV prevalence and plan geographically specific interventions, understanding the geospatial distribution of HIV seropositivity and its predictors among women plays a significant role. METHODS A spatial and multiscale geographically weighted regression analysis was conducted using the 2016 EDHS dataset, comprising 14,778 weighted samples of women in the reproductive age group. The EDHS sample underwent two-stage stratification and selection. The data were extracted between October 18 and 30, 2023. Non-spatial analysis was carried out using STATA version 17. Additionally, ArcGIS Pro and Sat Scan version 9.6 were used to visually map HIV seropositivity. Global Moran's I was computed to evaluate the distribution of HIV seropositivity. The Getis-Ord Gi* spatial statistic was utilized to identify significant spatial clusters of cold and hot spot areas. Geographically weighted regression analysis was subsequently performed to identify significant predictors of HIV seropositivity. Significance was established at a P-value <0.05 throughout all statistical analyses. RESULTS HIV seropositivity among women in Ethiopia is distributed non-randomly (Global Moran's I = 0.16, p-value <0.001 and Z-score = 7.12). Significant hotspot clustering of HIV seropositivity was found in the Addis Ababa, Harari, Dire Dawa, and Gambela region. Poor wealth index, being divorced and widowed, having more than one sexual partner, and early first sexual experience (<15 years) were found to be predictors of geographical variation of HIV seropositivity among women. CONCLUSION HIV seropositivity among women in Ethiopia varies geographically. Thus, deploying additional resources in high hotspot regions is recommended. Programs should focus on improving the economic empowerment of women to prevent the from engaging in risky sexual behaviors. Furthermore, comprehensive sex education programs in schools and community settings regarding the consequences of early first sexual debut might play a role in reducing HIV seropositivity among women in Ethiopia.
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Affiliation(s)
- Tegene Atamenta Kitaw
- Department of Nursing, College of Health Science, Woldia University, Woldia, Ethiopia
| | - Biruk Beletew Abate
- Department of Nursing, College of Health Science, Woldia University, Woldia, Ethiopia
| | - Befkad Derese Tilahun
- Department of Nursing, College of Health Science, Woldia University, Woldia, Ethiopia
| | - Ribka Nigatu Haile
- Department of Nursing, College of Health Science, Woldia University, Woldia, Ethiopia
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Abreu Martins C, Leal Seabra I, Rocha Vila Nova PV, Barbosa Rodrigues T, Oeiras Pedroso A, Gir E, Karina Reis R, Tavares Parente A, Oliveira Naiff Ferreira GR, Botelho EP. Spatial analysis of HIV detection rates among Brazilian young men, 2007-2021. AIDS Care 2024; 36:771-780. [PMID: 38227972 DOI: 10.1080/09540121.2024.2301730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 12/31/2023] [Indexed: 01/18/2024]
Abstract
The main goal of this study was to spatially analyze the HIV epidemic scenario in young men in Brazil, 2007-2021. We used secondary data obtained from the Brazilian Information System for Notifiable Diseases. Individuals aged 15-29 years with permanent residence in Brazil who were diagnosed with HIV during the study period were included in the analysis. Municipality HIV age-adjusted detection rates were analyzed through spatial distribution, autocorrelation, and spatiotemporal risk analyses. During the study period, 108,392 HIV cases were reported in young Brazilian men. The HIV epidemic increased territorially in the northern, northeastern, midwestern, and southeastern regions but decreased in the southern region. Although the number of clusters comprising municipalities with high HIV detection rates (hotspots) decreased, new ones appeared, expanded, or stopped changing size. Hotspots and spatio-temporal risk zones (spatial areas with increased HIV detection in a specific period) comprised economically developed municipalities with high demographic density surrounded by less developed municipalities. The period of the spatiotemporal risk zones was between 2008 and 2021. Our study showed that HIV detection rates continue to increase among young Brazilian men, and health authorities should reinforce efforts mainly in capitals and surrounded municipalities in the north, northeast, southeast, and midwest regions.
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Affiliation(s)
| | | | | | | | | | - Elucir Gir
- Nursing School of RibeirãoPreto, University of São Paulo, Ribeirão Preto, Brazil
| | - Renata Karina Reis
- Nursing School of RibeirãoPreto, University of São Paulo, Ribeirão Preto, Brazil
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Johnson KA, McDaniel JT, Graham HK, Robertson ET, McIntosh S, Wallace JP, Albright DL. A Geospatial Analysis of Social and Structural Determinants of Health and High HIV Prevalence in Alabama, USA. J Community Health 2024; 49:385-393. [PMID: 38032459 DOI: 10.1007/s10900-023-01309-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2023] [Indexed: 12/01/2023]
Abstract
OBJECTIVE This study utilizes geospatial analytic techniques to examine HIV hotspots in Alabama leveraging Medicaid utilization data. METHODS This cross-sectional study leveraged Medicaid utilization data from Alabama's 67 counties, averaging 9,861 Medicaid recipients aged > 18 years old per county. We used Alabama Medicaid administrative claims data from January 1, 2016, to December 31, 2020, to identify individuals with HIV. Using Microsoft SQL Server, we obtained the average annual count of HIV Medicaid claims in each of the 67 Alabama counties (numerator) and the number of adult Medicaid recipients in each county (denominator), and standardized with a multiplier of 100,000. We also examined several other area-level summary variables (e.g., non-high school completion, income greater than four times the federal poverty level, social associations, urbanicity/rurality) as social and structural determinants of health. County-boundary choropleth maps were created representing the geographic distribution of HIV rates per 100,000 adult Medicaid recipients in Alabama. Leveraging ESRI ArcGIS and local indicators of spatial association (LISA), results were examined using local Moran's I to identify geographic hotspots. RESULTS Eleven counties had HIV rates higher than 100 per 100,000. Three were hotspots. Being an HIV hotspot was significantly associated with relatively low educational attainment and less severe poverty than other areas in the state. CONCLUSIONS Findings suggesting that the HIV clusters in Alabama were categorized by significantly less severe poverty and lower educational attainment can aid ongoing efforts to strategically target resources and end the HIV epidemic in U.S.' Deep South.
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Affiliation(s)
- K A Johnson
- School of Social Work, The University of Alabama, Tuscaloosa, AL, USA
| | - J T McDaniel
- Public Health, Southern Illinois University, Carbondale, IL, USA
| | - H K Graham
- Educational Studies in Psychology, The University of Alabama, Tuscaloosa, AL, USA
| | - E T Robertson
- Department of Political Science, The University of Alabama, Box 870306, Tuscaloosa, AL, 35487-0314, USA
| | - S McIntosh
- Department of Political Science, The University of Alabama, Box 870306, Tuscaloosa, AL, 35487-0314, USA
| | - J P Wallace
- Public Health, Southern Illinois University, Carbondale, IL, USA
- School of Human Sciences, Southern Illinois University, Carbondale, IL, USA
| | - David L Albright
- Department of Political Science, The University of Alabama, Box 870306, Tuscaloosa, AL, 35487-0314, USA.
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de Lima LV, Pavinati G, de Oliveira RR, Couto RDM, Alves KBA, Magnabosco GT. Temporal trend in the incidence of tuberculosis-HIV coinfection in Brazil, by macro-region, Federative Unit, sex and age group, 2010-2021. EPIDEMIOLOGIA E SERVIÇOS DE SAÚDE 2024; 33:e2023522. [PMID: 38381874 PMCID: PMC10880441 DOI: 10.1590/s2237-96222024v33e2023522.en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 11/22/2023] [Indexed: 02/23/2024] Open
Abstract
OBJECTIVE To analyze the temporal trend in the incidence of tuberculosis-HIV coinfection in Brazil, by macro-region, Federative Unit, sex and age group, from 2010 to 2021. METHODS This was a time series study using surveillance data to estimate average annual percentage changes (AAPC), and 95% confidence intervals (95%CI) via joinpoint regression. RESULTS 122,211 cases of tuberculosis-HIV coinfection were analyzed; a falling trend was identified for Brazil as a whole (AAPC = -4.3; 95%CI -5.1;-3.7), and in the country's Southern (AAPC = -6.2; 95%CI -6.9;-5.5) and Southeast (AAPC = -4.6; 95%CI -5.6;-3.8) regions, even more so during the COVID-19 pandemic (2020-2021); the greatest falling trend was seen in Santa Catarina (AAPC = -9.3; 95%CI -10.1;-8.5), while the greatest rising trend was found in Tocantins (AAPC = 4.1; 95%CI 0.1;8.6); there was a rising trend among males, especially in Sergipe (AAPC = 3.9; 95%CI 0.4;7.9), and those aged 18 to 34 years, especially in Amapá (AAPC = 7.9; 95%CI 5.1;11.5). CONCLUSION The burden and trends of tuberculosis-HIV coinfection were geographically and demographically disparate.
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Affiliation(s)
- Lucas Vinícius de Lima
- Universidade Estadual de Maringá, Programa de Pós-Graduação em
Enfermagem, Maringá, PR, Brazil
| | - Gabriel Pavinati
- Universidade Estadual de Maringá, Programa de Pós-Graduação em
Enfermagem, Maringá, PR, Brazil
| | | | | | - Kleydson Bonfim Andrade Alves
- Organização Pan-Americana da Saúde, Departamento de Doenças
Transmissíveis e Determinantes Ambientais da Saúde, Brasília, DF, Brazil
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Zapata JP, Queiroz A, Rodriguez-Diaz CE, Mustanski B. Factors Associated with HIV Testing Among Spanish and English-Speaking Latino Adolescents Aged 13-18. AIDS Behav 2024; 28:343-356. [PMID: 37848599 DOI: 10.1007/s10461-023-04206-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2023] [Indexed: 10/19/2023]
Abstract
Adolescent Latino men who have sex with men (LMSM) in the U.S. are disproportionately impacted by HIV. However, there has been limited focus on their HIV prevention and risk behaviors. In this study, we examine the rates of HIV testing and explore the significant demographic and healthcare factors that influence HIV prevention among adolescent LMSM. The analysis for this study utilized data collected during the baseline assessment of SMART, a pragmatic trial aimed at evaluating the effectiveness of an online HIV prevention intervention for adolescent LMSM (N = 524). Only 35.5% of participants had ever had an HIV test in their lifetime. Rates of testing increased among adolescent LMSM who had a doctor with whom they spoke about their sexual health (odds ratio: 4.0; 95% confidence interval: 2.1-8.4; P < 0.001) or HIV testing (odds ratio: 5.8; 95% confidence interval: 3.1-10.7; P < 0.001). Out of the 61 participants who took part in the survey conducted in Spanish, only 26% reported ever having an HIV test. Additionally, 24.5% stated that they had discussed their sexual orientation with a doctor, and only 8.2% had undergone HIV testing. Spanish-speaking adolescents who completed the SMART survey were less likely to openly discuss their sexual orientation or sexual health with most people or have a doctor with whom they discussed these topics, compared to those who completed the survey in English. These findings suggest that Spanish-speaking adolescent LMSM may face obstacles in accessing HIV prevention services in the U.S.
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Affiliation(s)
- Juan Pablo Zapata
- Department of Medical Social Science and the Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N Michigan Ave, Chicago, IL, USA
| | - Artur Queiroz
- Department of Medical Social Science and the Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N Michigan Ave, Chicago, IL, USA
| | - Carlos E Rodriguez-Diaz
- School of Public Health, Boston University, 801 Massachusetts Ave. Suite 431, Boston, MA, USA
| | - Brian Mustanski
- Department of Medical Social Science and the Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N Michigan Ave, Chicago, IL, USA.
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Perotta M, Rosa SVD, Raymundo GP, Silva ROCD, Werneck RI, Orsi JSR, Moysés SJ. Sociodemographic profile and gestacional aspects of women with hiv/aids in Curitiba, Brazil. Rev Gaucha Enferm 2023; 44:e20220202. [PMID: 37585957 DOI: 10.1590/1983-1447.2023.20220202.en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 01/09/2023] [Indexed: 08/18/2023] Open
Abstract
OBJECTIVE To describe the sociodemographic and gestational profile of HIV-positive women in Curitiba-PR, years 2018-2020. METHOD Observational, cross-sectional research, with data obtained from the Information System of Diseases of Notification of Pregnant Women. Data were analyzed for consistency exploration, description and analysis. RESULTS The sample consisted mostly of women aged 13-30 years, white and with incomplete elementary school. Prenatal care was performed by 93.8% of pregnant women, 66.1% of whom knew their serological status before prenatal care and 45% received notification in the first gestational trimester. Access to antiretroviral medication occurred for 82.4% of pregnant women and for 74.6% the pregnancy outcome was alive newborns. The statistical variables associated with prenatal care were pregnancy evolution, ART prophylaxis, type of delivery and ART at delivery (p<0.00). CONCLUSION The pregnant women in the sample presented desired gestational indicators. The collected data allowed describing the sample's profile and evaluating the performance of the health policy for pregnant women.
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Affiliation(s)
- Mariana Perotta
- Pontifícia Universidade Católica do Paraná (PUC-PR), Faculdade de Ciências da Vida. Curitiba, Paraná, Brasil
| | - Saulo Vinicius da Rosa
- Pontifícia Universidade Católica do Paraná (PUC-PR), Faculdade de Ciências da Vida. Curitiba, Paraná, Brasil
| | - Gisele Pontaroli Raymundo
- Pontifícia Universidade Católica do Paraná (PUC-PR), Faculdade de Ciências da Vida. Curitiba, Paraná, Brasil
| | | | - Renata Iani Werneck
- Pontifícia Universidade Católica do Paraná (PUC-PR), Faculdade de Ciências da Vida. Curitiba, Paraná, Brasil
| | - Juliana Schaia Rocha Orsi
- Pontifícia Universidade Católica do Paraná (PUC-PR), Faculdade de Ciências da Vida. Curitiba, Paraná, Brasil
| | - Samuel Jorge Moysés
- Pontifícia Universidade Católica do Paraná (PUC-PR), Faculdade de Ciências da Vida. Curitiba, Paraná, Brasil
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Mnkai J, Ritter M, Maganga L, Maboko L, Olomi W, Clowes P, Minich J, Lelo AE, Kariuki D, Debrah AY, Geldmacher C, Hoelscher M, Saathoff E, Chachage M, Pfarr K, Hoerauf A, Kroidl I. Increased HIV Incidence in Wuchereria bancrofti Microfilaria Positive Individuals in Tanzania. Pathogens 2023; 12:pathogens12030387. [PMID: 36986309 PMCID: PMC10054595 DOI: 10.3390/pathogens12030387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 02/23/2023] [Accepted: 02/24/2023] [Indexed: 03/05/2023] Open
Abstract
Background: Infections with Wuchereria bancrofti are associated with reduced immunity against concomitant infections. Indeed, our previous study described a 2.3-fold increased HIV incidence among individuals with W. bancrofti infection, as measured by the circulating filarial antigen of the adult worm. This new study aimed to retrospectively determine microfilariae status of the participants to assess if the previously described increased HIV susceptibility was associated with the presence of MF in the same cohort. Methods: CFA positive but HIV negative biobanked human blood samples (n = 350) were analyzed for W. bancrofti MF chitinase using real time PCR. Results: The PCR provided a positive signal in 12/350 (3.4%) samples. During four years of follow-up (1109 person years (PY)), 22 study participants acquired an HIV infection. In 39 PY of W. bancrofti MF chitinase positive individuals, three new HIV infections occurred (7.8 cases per 100 PY), in contrast to 19 seroconversions in 1070 PY of W. bancrofti MF chitinase negative individuals (1.8 cases per 100 PY, p = 0.014). Conclusions: In the subgroup of MF-producing Wb-infected individuals, the HIV incidence exceeded the previously described moderate increased risk for HIV seen in all Wb-infected individuals (regardless of MF status) compared with uninfected persons from the same area.
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Affiliation(s)
- Jonathan Mnkai
- National Institute of Medical Research (NIMR), Mbeya Medical Research Center (MMRC), Mbeya P.O. Box 2410, Tanzania
| | - Manuel Ritter
- Institute for Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn (UKB), 53127 Bonn, Germany
| | - Lucas Maganga
- National Institute of Medical Research (NIMR), Mbeya Medical Research Center (MMRC), Mbeya P.O. Box 2410, Tanzania
| | - Leonard Maboko
- National Institute of Medical Research (NIMR), Mbeya Medical Research Center (MMRC), Mbeya P.O. Box 2410, Tanzania
- Tanzania Commission for AIDS, Dodoma P.O. Box 2904, Tanzania
| | - Willyhelmina Olomi
- National Institute of Medical Research (NIMR), Mbeya Medical Research Center (MMRC), Mbeya P.O. Box 2410, Tanzania
| | - Petra Clowes
- National Institute of Medical Research (NIMR), Mbeya Medical Research Center (MMRC), Mbeya P.O. Box 2410, Tanzania
| | - Jessica Minich
- Institute for Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn (UKB), 53127 Bonn, Germany
| | - Agola Eric Lelo
- Kenya Medical Research Institute (KEMRI), KNH, Nairobi, Kenya
| | - Daniel Kariuki
- College of Health Sciences, Jomo Kenyatta University of Agriculture and Technology (JKUAT), Juja, Kenya
| | - Alexander Yaw Debrah
- Kumasi Centre for Collaborative Research (KCCR), Kwame Nkrumah University of Science and Technology, UPO, PMB, Kumasi, Ghana
| | - Christof Geldmacher
- Division of Infectious Diseases and Tropical Medicine, University Hospital of the University of Munich (LMU), 80802 Munich, Germany
- German Centre for Infection Research (DZIF), Partner Site Munich, 80802 Munich, Germany
| | - Michael Hoelscher
- Division of Infectious Diseases and Tropical Medicine, University Hospital of the University of Munich (LMU), 80802 Munich, Germany
- German Centre for Infection Research (DZIF), Partner Site Munich, 80802 Munich, Germany
| | - Elmar Saathoff
- Division of Infectious Diseases and Tropical Medicine, University Hospital of the University of Munich (LMU), 80802 Munich, Germany
- German Centre for Infection Research (DZIF), Partner Site Munich, 80802 Munich, Germany
| | - Mkunde Chachage
- National Institute of Medical Research (NIMR), Mbeya Medical Research Center (MMRC), Mbeya P.O. Box 2410, Tanzania
- Mbeya College of Health and Allied Sciences (UDSM-MCHAS), University of Dar es Salaam, Mbeya 608, Tanzania
| | - Kenneth Pfarr
- Institute for Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn (UKB), 53127 Bonn, Germany
- German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, 53127 Bonn, Germany
| | - Achim Hoerauf
- Institute for Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn (UKB), 53127 Bonn, Germany
- German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, 53127 Bonn, Germany
- German-West African Centre for Global Health and Pandemic Prevention (G-WAC), Partner Site Bonn, 53127 Bonn, Germany
| | - Inge Kroidl
- Division of Infectious Diseases and Tropical Medicine, University Hospital of the University of Munich (LMU), 80802 Munich, Germany
- German Centre for Infection Research (DZIF), Partner Site Munich, 80802 Munich, Germany
- Correspondence:
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