Department of Global Health, Research School of Population Health, Australian National University, Canberra, ACT 2601, Australia.
Int J Environ Res Public Health. 2021 Mar 25;18(7):3424. doi: 10.3390/ijerph18073424.
Botswana has the third highest human immunodeficiency virus (HIV) prevalence globally, and the severity of the epidemic within the country varies considerably between the districts. This study aimed to identify clusters of HIV and associated factors among adults in Botswana. Data from the Botswana Acquired Immunodeficiency Syndrome (AIDS) Impact Survey IV (BIAS IV), a nationally representative household-based survey, were used for this study. Multivariable logistic regression and Kulldorf's scan statistics were used to identify the risk factors and HIV clusters. Socio-demographic characteristics were compared within and outside the clusters. HIV prevalence among the study participants was 25.1% (95% CI 23.3-26.4). HIV infection was significantly higher among the female gender, those older than 24 years and those reporting the use of condoms, while tertiary education had a protective effect. Two significant HIV clusters were identified, one located between Selibe-Phikwe and Francistown and another in the Central Mahalapye district. Clusters had higher levels of unemployment, less people with tertiary education and more people residing in rural areas compared to regions outside the clusters. Our study identified high-risk populations and regions with a high burden of HIV infection in Botswana. This calls for focused innovative and cost-effective HIV interventions on these vulnerable populations and regions to curb the HIV epidemic in Botswana.
博茨瓦纳的人类免疫缺陷病毒（HIV）感染率居全球第三，且该国各地区的疫情严重程度存在显著差异。本研究旨在确定博茨瓦纳成年人中 HIV 感染的聚集区及其相关因素。本研究使用了博茨瓦纳获得性免疫缺陷综合征（AIDS）影响调查 IV（BIAS IV）的数据，该调查是一项具有全国代表性的家庭为基础的调查。多变量逻辑回归和 Kulldorf 的扫描统计用于识别危险因素和 HIV 聚集区。对聚集区内外的社会人口特征进行了比较。研究参与者的 HIV 感染率为 25.1%（95%置信区间 23.3-26.4）。女性、年龄大于 24 岁和报告使用避孕套的人群中 HIV 感染率显著较高，而接受高等教育则具有保护作用。确定了两个具有显著意义的 HIV 聚集区，一个位于塞莱比-皮奎和弗朗西斯敦之间，另一个位于中央马哈莱普耶地区。与聚集区以外的地区相比，聚集区的失业率更高，接受高等教育的人数更少，居住在农村地区的人数更多。我们的研究确定了博茨瓦纳高危人群和 HIV 感染负担较高的地区。这需要针对这些脆弱人群和地区采取有针对性的创新和具有成本效益的 HIV 干预措施，以遏制博茨瓦纳的 HIV 疫情。
