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Geographical Patterns of HIV Sero-Discordancy in High HIV Prevalence Countries in Sub-Saharan Africa

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,...

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Autores principales: Cuadros, Diego F., Abu-Raddad, Laith J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5036698/
https://www.ncbi.nlm.nih.gov/pubmed/27589776
http://dx.doi.org/10.3390/ijerph13090865
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author Cuadros, Diego F.
Abu-Raddad, Laith J.
author_facet Cuadros, Diego F.
Abu-Raddad, Laith J.
author_sort Cuadros, Diego F.
collection PubMed
description 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.
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spelling pubmed-50366982016-09-29 Geographical Patterns of HIV Sero-Discordancy in High HIV Prevalence Countries in Sub-Saharan Africa Cuadros, Diego F. Abu-Raddad, Laith J. Int J Environ Res Public Health Article 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. MDPI 2016-08-31 2016-09 /pmc/articles/PMC5036698/ /pubmed/27589776 http://dx.doi.org/10.3390/ijerph13090865 Text en © 2016 by the authors; licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Cuadros, Diego F.
Abu-Raddad, Laith J.
Geographical Patterns of HIV Sero-Discordancy in High HIV Prevalence Countries in Sub-Saharan Africa
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 Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5036698/
https://www.ncbi.nlm.nih.gov/pubmed/27589776
http://dx.doi.org/10.3390/ijerph13090865
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