Assessing spatial patterns of HIV prevalence and interventions in semi-urban settings in South Africa. Implications for spatially targeted interventions
Equitable allocation of resources targeting the human immunodeficiency virus (HIV) at the local level requires focusing interventions in areas of the greatest need. Understanding the geographical variation in the HIV epidemic and uptake of selected HIV prevention and treatment programmes are necess...
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| Format: | Article |
| Language: | English |
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PAGEPress Publications
2022-08-01
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| Series: | Geospatial Health |
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| Online Access: | https://www.geospatialhealth.net/index.php/gh/article/view/1084 |
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| author | Lucy Chimoyi Zvifadzo Matsena-Zingoni Salome Charalambous Edmore Marinda Samuel Manda Eustasius Musenge |
| author_facet | Lucy Chimoyi Zvifadzo Matsena-Zingoni Salome Charalambous Edmore Marinda Samuel Manda Eustasius Musenge |
| author_sort | Lucy Chimoyi |
| collection | DOAJ |
| description |
Equitable allocation of resources targeting the human immunodeficiency virus (HIV) at the local level requires focusing interventions in areas of the greatest need. Understanding the geographical variation in the HIV epidemic and uptake of selected HIV prevention and treatment programmes are necessary to identify such areas. Individual-level HIV data were obtained from a 2012 national HIV survey in South Africa. Spatial regression models on each outcome measure (HIV infection, sub-optimal condom use or non-anti-retroviral treatment (ART) adjusted for spatial random effects at the ward level were fitted using WINBUGS software. In addition, ward-level data was utilized to estimate condom use coverage and ART initiation rates which were obtained from routinely collected data in 2012. Ordinary Kriging was used to produce smoothed maps of HIV infection, condom use coverage and ART initiation rates. HIV infection was associated with individuals undertaking tertiary education [posterior odds ratio (POR): 19.53; 95% credible intervals (CrI): 3.22- 84.93]. Sub-optimal condom use increased with age (POR: 1.09; 95%CrI: 1.06-1.11) and was associated with being married (POR: 4.14; 95%CrI: 1.23-4.28). Non-ART use was associated with being married (POR: 6.79; 95%CrI: 1.43-22.43). There were clusters with high HIV infection, sub-optimal condom use, and non- ART use in Ekurhuleni, an urban and semi-urban district in Gauteng province, South Africa. Findings show the need for expanding condom programmes and/or strengthening other HIV prevention programmes such as pre-exposure prophylaxis and encouraging sustained engagement in HIV care and treatment in the identified areas with the greatest need in Ekurhuleni Metropolitan Municipality.
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| first_indexed | 2024-04-13T01:58:32Z |
| format | Article |
| id | doaj.art-bb9ce243884c47a5943a17864a6e7b86 |
| institution | Directory Open Access Journal |
| issn | 1827-1987 1970-7096 |
| language | English |
| last_indexed | 2024-04-13T01:58:32Z |
| publishDate | 2022-08-01 |
| publisher | PAGEPress Publications |
| record_format | Article |
| series | Geospatial Health |
| spelling | doaj.art-bb9ce243884c47a5943a17864a6e7b862022-12-22T03:07:41ZengPAGEPress PublicationsGeospatial Health1827-19871970-70962022-08-0117210.4081/gh.2022.1084Assessing spatial patterns of HIV prevalence and interventions in semi-urban settings in South Africa. Implications for spatially targeted interventionsLucy Chimoyi0Zvifadzo Matsena-Zingoni1Salome Charalambous2Edmore Marinda3Samuel Manda4Eustasius Musenge5Implementation Research Division, The Aurum Institute, Johannesburg; School of Public Health, University of the Witwatersrand, JohannesburgSchool of Public Health, University of the Witwatersrand, JohannesburgImplementation Research Division, The Aurum Institute, Johannesburg; School of Public Health, University of the Witwatersrand, JohannesburgSchool of Public Health, University of the Witwatersrand, Johannesburg; Human Sciences Research Council, PretoriaBiostatistics Research Unit, South African Medical Research Council, Pretoria; Department of Statistics, University of Pretoria, PretoriaSchool of Public Health, University of the Witwatersrand, Johannesburg Equitable allocation of resources targeting the human immunodeficiency virus (HIV) at the local level requires focusing interventions in areas of the greatest need. Understanding the geographical variation in the HIV epidemic and uptake of selected HIV prevention and treatment programmes are necessary to identify such areas. Individual-level HIV data were obtained from a 2012 national HIV survey in South Africa. Spatial regression models on each outcome measure (HIV infection, sub-optimal condom use or non-anti-retroviral treatment (ART) adjusted for spatial random effects at the ward level were fitted using WINBUGS software. In addition, ward-level data was utilized to estimate condom use coverage and ART initiation rates which were obtained from routinely collected data in 2012. Ordinary Kriging was used to produce smoothed maps of HIV infection, condom use coverage and ART initiation rates. HIV infection was associated with individuals undertaking tertiary education [posterior odds ratio (POR): 19.53; 95% credible intervals (CrI): 3.22- 84.93]. Sub-optimal condom use increased with age (POR: 1.09; 95%CrI: 1.06-1.11) and was associated with being married (POR: 4.14; 95%CrI: 1.23-4.28). Non-ART use was associated with being married (POR: 6.79; 95%CrI: 1.43-22.43). There were clusters with high HIV infection, sub-optimal condom use, and non- ART use in Ekurhuleni, an urban and semi-urban district in Gauteng province, South Africa. Findings show the need for expanding condom programmes and/or strengthening other HIV prevention programmes such as pre-exposure prophylaxis and encouraging sustained engagement in HIV care and treatment in the identified areas with the greatest need in Ekurhuleni Metropolitan Municipality. https://www.geospatialhealth.net/index.php/gh/article/view/1084HIV preventionHIV treatmentspatial heterogeneitytargeted interventionsBayesianSouth Africa. |
| spellingShingle | Lucy Chimoyi Zvifadzo Matsena-Zingoni Salome Charalambous Edmore Marinda Samuel Manda Eustasius Musenge Assessing spatial patterns of HIV prevalence and interventions in semi-urban settings in South Africa. Implications for spatially targeted interventions Geospatial Health HIV prevention HIV treatment spatial heterogeneity targeted interventions Bayesian South Africa. |
| title | Assessing spatial patterns of HIV prevalence and interventions in semi-urban settings in South Africa. Implications for spatially targeted interventions |
| title_full | Assessing spatial patterns of HIV prevalence and interventions in semi-urban settings in South Africa. Implications for spatially targeted interventions |
| title_fullStr | Assessing spatial patterns of HIV prevalence and interventions in semi-urban settings in South Africa. Implications for spatially targeted interventions |
| title_full_unstemmed | Assessing spatial patterns of HIV prevalence and interventions in semi-urban settings in South Africa. Implications for spatially targeted interventions |
| title_short | Assessing spatial patterns of HIV prevalence and interventions in semi-urban settings in South Africa. Implications for spatially targeted interventions |
| title_sort | assessing spatial patterns of hiv prevalence and interventions in semi urban settings in south africa implications for spatially targeted interventions |
| topic | HIV prevention HIV treatment spatial heterogeneity targeted interventions Bayesian South Africa. |
| url | https://www.geospatialhealth.net/index.php/gh/article/view/1084 |
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