Has the relationship between wealth and HIV risk in Sub-Saharan Africa changed over time? A temporal, gendered and hierarchical analysis
This study examines the relationship between wealth and HIV infection in Sub-Saharan Africa to determine whether and how this relationship has varied over time, within and across countries, by gender, and urban environment. The analysis draws on DHS and AIS data from 27 Sub-Saharan African countries...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2021-09-01
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| Series: | SSM: Population Health |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352827321001087 |
| _version_ | 1818882409479798784 |
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| author | Emily Andrus Sanyu A. Mojola Elizabeth Moran Marisa Eisenberg Jon Zelner |
| author_facet | Emily Andrus Sanyu A. Mojola Elizabeth Moran Marisa Eisenberg Jon Zelner |
| author_sort | Emily Andrus |
| collection | DOAJ |
| description | This study examines the relationship between wealth and HIV infection in Sub-Saharan Africa to determine whether and how this relationship has varied over time, within and across countries, by gender, and urban environment. The analysis draws on DHS and AIS data from 27 Sub-Saharan African countries, which spanned the 14 years between 2003 and 2016. We first use logistic regression analyses to assess the relationship between individual wealth, HIV infection and gender by country and year stratified on urban environment. We then use meta-regression analyses to assess the relationship between country level measures of wealth and the odds of HIV infection by gender and individual level wealth, stratified on urban environment. We find that there is a persistent and positive relationship between wealth and the odds of HIV infection across countries, but that the strength of this association has weakened over time. The rate of attenuation does not appear to differ between urban/rural strata. Likewise, we also find that these associations were most pronounced for women and that this relationship was persistent over the study period and across urban and rural strata. Overall, our findings suggest that the relationship between wealth and HIV infection is beginning to reverse and that in the coming years, the relationship between wealth and HIV infection in Sub-Saharan Africa may more clearly mirror the predominant global picture. |
| first_indexed | 2024-12-19T15:17:18Z |
| format | Article |
| id | doaj.art-18d105b078ce4565b33d246a8d48363f |
| institution | Directory Open Access Journal |
| issn | 2352-8273 |
| language | English |
| last_indexed | 2024-12-19T15:17:18Z |
| publishDate | 2021-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | SSM: Population Health |
| spelling | doaj.art-18d105b078ce4565b33d246a8d48363f2022-12-21T20:16:07ZengElsevierSSM: Population Health2352-82732021-09-0115100833Has the relationship between wealth and HIV risk in Sub-Saharan Africa changed over time? A temporal, gendered and hierarchical analysisEmily Andrus0Sanyu A. Mojola1Elizabeth Moran2Marisa Eisenberg3Jon Zelner4University of Michigan, Department of Epidemiology, School of Public Health, Ann Arbor, MI, USA; Corresponding author. 1415 Washington Heights, Department of Epidemiology, SPH II, M5326, Ann Arbor, MI, 48109, USA.Department of Sociology, School of Public and International Affairs, Office of Population Research, Princeton University, Princeton, NJ, USAUniversity of Michigan, Department of Epidemiology, School of Public Health, Ann Arbor, MI, USAUniversity of Michigan, Department of Epidemiology, School of Public Health, Ann Arbor, MI, USAUniversity of Michigan, Department of Epidemiology, School of Public Health, Ann Arbor, MI, USAThis study examines the relationship between wealth and HIV infection in Sub-Saharan Africa to determine whether and how this relationship has varied over time, within and across countries, by gender, and urban environment. The analysis draws on DHS and AIS data from 27 Sub-Saharan African countries, which spanned the 14 years between 2003 and 2016. We first use logistic regression analyses to assess the relationship between individual wealth, HIV infection and gender by country and year stratified on urban environment. We then use meta-regression analyses to assess the relationship between country level measures of wealth and the odds of HIV infection by gender and individual level wealth, stratified on urban environment. We find that there is a persistent and positive relationship between wealth and the odds of HIV infection across countries, but that the strength of this association has weakened over time. The rate of attenuation does not appear to differ between urban/rural strata. Likewise, we also find that these associations were most pronounced for women and that this relationship was persistent over the study period and across urban and rural strata. Overall, our findings suggest that the relationship between wealth and HIV infection is beginning to reverse and that in the coming years, the relationship between wealth and HIV infection in Sub-Saharan Africa may more clearly mirror the predominant global picture.http://www.sciencedirect.com/science/article/pii/S2352827321001087HIVWealthGenderSub-saharan AfricaSpatial-temporal epidemiology |
| spellingShingle | Emily Andrus Sanyu A. Mojola Elizabeth Moran Marisa Eisenberg Jon Zelner Has the relationship between wealth and HIV risk in Sub-Saharan Africa changed over time? A temporal, gendered and hierarchical analysis SSM: Population Health HIV Wealth Gender Sub-saharan Africa Spatial-temporal epidemiology |
| title | Has the relationship between wealth and HIV risk in Sub-Saharan Africa changed over time? A temporal, gendered and hierarchical analysis |
| title_full | Has the relationship between wealth and HIV risk in Sub-Saharan Africa changed over time? A temporal, gendered and hierarchical analysis |
| title_fullStr | Has the relationship between wealth and HIV risk in Sub-Saharan Africa changed over time? A temporal, gendered and hierarchical analysis |
| title_full_unstemmed | Has the relationship between wealth and HIV risk in Sub-Saharan Africa changed over time? A temporal, gendered and hierarchical analysis |
| title_short | Has the relationship between wealth and HIV risk in Sub-Saharan Africa changed over time? A temporal, gendered and hierarchical analysis |
| title_sort | has the relationship between wealth and hiv risk in sub saharan africa changed over time a temporal gendered and hierarchical analysis |
| topic | HIV Wealth Gender Sub-saharan Africa Spatial-temporal epidemiology |
| url | http://www.sciencedirect.com/science/article/pii/S2352827321001087 |
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