尼日利亚男男性行为者和注射毒品者中的 HIV 血清流行率的地理差异：探索性空间数据分析。
Geographical Disparities in HIV Seroprevalence Among Men Who Have Sex with Men and People Who Inject Drugs in Nigeria: Exploratory Spatial Data Analysis.
机构信息
Institute of Global Health, University of Geneva, Geneva, Switzerland.
U S Agency for International Development, Abuja, Nigeria.
出版信息
JMIR Public Health Surveill. 2021 May 24;7(5):e19587. doi: 10.2196/19587.
BACKGROUND
The assessment of geographical heterogeneity of HIV among men who have sex with men (MSM) and people who inject drugs (PWID) can usefully inform targeted HIV prevention and care strategies.
OBJECTIVE
We aimed to measure HIV seroprevalence and identify hotspots of HIV infection among MSM and PWID in Nigeria.
METHODS
We included all MSM and PWID accessing HIV testing services across 7 prioritized states (Lagos, Nasarawa, Akwa Ibom, Cross Rivers, Rivers, Benue, and the Federal Capital Territory) in 3 geographic regions (North Central, South South, and South West) between October 1, 2016, and September 30, 2017. We extracted data from national testing registers, georeferenced all HIV test results aggregated at the local government area level, and calculated HIV seroprevalence. We calculated and compared HIV seroprevalence from our study to the 2014 integrated biological and behavioural surveillance survey and used global spatial autocorrelation and hotspot analysis to highlight patterns of HIV infection and identify areas of significant clustering of HIV cases.
RESULTS
MSM and PWID had HIV seroprevalence rates of 12.14% (3209/26,423) and 11.88% (1126/9474), respectively. Global spatial autocorrelation Moran I statistics revealed a clustered distribution of HIV infection among MSM and PWID with a <5% and <1% likelihood that this clustered pattern could be due to chance, respectively. Significant clusters of HIV infection (Getis-Ord-Gi* statistics) confined to the North Central and South South regions were identified among MSM and PWID. Compared to the 2014 integrated biological and behavioural surveillance survey, our results suggest an increased HIV seroprevalence among PWID and a substantial decrease among MSM.
CONCLUSIONS
This study identified geographical areas to prioritize for control of HIV infection among MSM and PWID, thus demonstrating that geographical information system technology is a useful tool to inform public health planning for interventions targeting epidemic control of HIV infection.
背景
评估男男性行为者（MSM）和注射吸毒者（PWID）中 HIV 的地理异质性，可以为有针对性的 HIV 预防和护理策略提供有用信息。
目的
我们旨在测量尼日利亚 MSM 和 PWID 中的 HIV 血清流行率，并确定 HIV 感染的热点地区。
方法
我们纳入了 2016 年 10 月 1 日至 2017 年 9 月 30 日期间，在 3 个地理区域（中北部、南部和西南部）的 7 个优先州（拉各斯、纳萨拉瓦、阿克瓦伊博姆、十字河、河流、贝努埃和联邦首都地区）接受 HIV 检测服务的所有 MSM 和 PWID。我们从国家检测登记处提取数据，将所有 HIV 检测结果按地方政府区域汇总，并计算 HIV 血清流行率。我们计算并比较了本研究中的 HIV 血清流行率与 2014 年综合生物和行为监测调查，并使用全球空间自相关和热点分析来突出 HIV 感染模式，并确定 HIV 病例的显著聚类区域。
结果
MSM 和 PWID 的 HIV 血清流行率分别为 12.14%（3209/26423）和 11.88%（1126/9474）。MSM 和 PWID 的全球空间自相关 Moran I 统计数据显示，HIV 感染呈聚类分布，其聚类模式出现的可能性<5%和<1%。分别在 MSM 和 PWID 中发现了局限于中北部和南部地区的 HIV 感染显著聚类（Getis-Ord-Gi*统计量）。与 2014 年综合生物和行为监测调查相比，我们的结果表明 PWID 中的 HIV 血清流行率增加，而 MSM 中的 HIV 血清流行率显著下降。
结论
本研究确定了需要优先控制 MSM 和 PWID 中 HIV 感染的地理区域，因此表明地理信息系统技术是一种有用的工具，可以为针对 HIV 感染控制的干预措施提供公共卫生规划信息。
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