Institute for Health Metrics and Evaluation, Seattle, WA, USA.
AIDS Behav. 2021 Nov;25(Suppl 2):145-154. doi: 10.1007/s10461-021-03279-9. Epub 2021 Jun 5.
HIV incidence in sub-Saharan Africa declined substantially between 2000 and 2015. In this analysis, we consider the relative associations of nine structural and individual determinants with this decline. A linear mixed effects model of logged HIV incidence rates versus determinants was used. The data were from mathematical modelling as part of the 2019 Global Burden of Disease Study in 43 sub-Saharan African countries. We used forwards selection to determine a single final model of HIV incidence rate. The association of economic variables and HIV knowledge with incidence was found to be driven by education, while ART coverage had the largest impact on other determinants' coefficients. In the final model, education years per capita contributed the most to explaining variation in HIV incidence rates; a 1-year increase in mean education years was associated with a 0.39 (- 0.56; - 0.2, t = - 4.48 p < 0.01) % decline in incidence rate while a unit increase in ART coverage was associated with a 0.81 (- 1.34; - 0.28, t = - 3.01, p < 0.01) % decline in incidence rate.
HIV 发病率在撒哈拉以南非洲地区 2000 年至 2015 年间大幅下降。在本分析中，我们考虑了九个结构和个体决定因素与这种下降的相对关联。使用对数 HIV 发病率与决定因素的线性混合效应模型进行分析。这些数据来自数学建模，是 2019 年全球疾病负担研究中 43 个撒哈拉以南非洲国家的一部分。我们使用前向选择确定 HIV 发病率的单一最终模型。发现经济变量和 HIV 知识与发病率的关联受教育程度驱动，而抗逆转录病毒治疗（ART）覆盖率对其他决定因素的系数影响最大。在最终模型中，人均受教育年限对解释 HIV 发病率的变化贡献最大；平均受教育年限增加 1 年，与发病率下降 0.39%（-0.56；-0.20，t=-4.48，p<0.01）相关，而 ART 覆盖率增加 1 单位，与发病率下降 0.81%（-1.34；-0.28，t=-3.01，p<0.01）相关。
