Department of Nursing, College of Health Science, Woldia University, Woldia, Ethiopia.
PLoS One. 2024 Jul 11;19(7):e0306645. doi: 10.1371/journal.pone.0306645. eCollection 2024.
Although promising efforts have been made so far, HIV remains a public health concern. Women in Ethiopia are disproportionately affected by HIV, accounting for a majority of new infections and AIDS-related deaths. However, the geospatial distribution of HIV among women in Ethiopia is not well understood, making it challenging to develop geographically targeted measures. Besides, to accelerate the pathway of decreasing HIV prevalence and plan geographically specific interventions, understanding the geospatial distribution of HIV seropositivity and its predictors among women plays a significant role.
A spatial and multiscale geographically weighted regression analysis was conducted using the 2016 EDHS dataset, comprising 14,778 weighted samples of women in the reproductive age group. The EDHS sample underwent two-stage stratification and selection. The data were extracted between October 18 and 30, 2023. Non-spatial analysis was carried out using STATA version 17. Additionally, ArcGIS Pro and Sat Scan version 9.6 were used to visually map HIV seropositivity. Global Moran's I was computed to evaluate the distribution of HIV seropositivity. The Getis-Ord Gi* spatial statistic was utilized to identify significant spatial clusters of cold and hot spot areas. Geographically weighted regression analysis was subsequently performed to identify significant predictors of HIV seropositivity. Significance was established at a P-value <0.05 throughout all statistical analyses.
HIV seropositivity among women in Ethiopia is distributed non-randomly (Global Moran's I = 0.16, p-value <0.001 and Z-score = 7.12). Significant hotspot clustering of HIV seropositivity was found in the Addis Ababa, Harari, Dire Dawa, and Gambela region. Poor wealth index, being divorced and widowed, having more than one sexual partner, and early first sexual experience (<15 years) were found to be predictors of geographical variation of HIV seropositivity among women.
HIV seropositivity among women in Ethiopia varies geographically. Thus, deploying additional resources in high hotspot regions is recommended. Programs should focus on improving the economic empowerment of women to prevent the from engaging in risky sexual behaviors. Furthermore, comprehensive sex education programs in schools and community settings regarding the consequences of early first sexual debut might play a role in reducing HIV seropositivity among women in Ethiopia.
尽管迄今为止已经做出了有希望的努力，但艾滋病毒仍然是一个公共卫生问题。埃塞俄比亚的女性受艾滋病毒的影响不成比例，占新感染和艾滋病相关死亡的大多数。然而，埃塞俄比亚女性中的艾滋病毒的地理分布情况并不清楚，这使得制定有针对性的地理措施具有挑战性。此外，为了加速降低艾滋病毒流行率的途径并规划具有地理针对性的干预措施，了解艾滋病毒血清阳性率的地理空间分布及其预测因素对于女性来说具有重要意义。
使用 2016 年 EDHS 数据集进行空间和多尺度地理加权回归分析，该数据集包含 14778 名处于生育年龄组的女性加权样本。EDHS 样本经过两阶段分层和选择。数据于 2023 年 10 月 18 日至 30 日提取。非空间分析使用 STATA 版本 17 进行。此外，ArcGIS Pro 和 Sat Scan 版本 9.6 用于直观地绘制艾滋病毒血清阳性率。计算全局 Moran's I 以评估艾滋病毒血清阳性率的分布。使用 Getis-Ord Gi* 空间统计量识别冷热点区域的显著空间聚类。随后进行地理加权回归分析，以确定艾滋病毒血清阳性率的显著预测因素。在所有统计分析中，以 P 值<0.05 作为显著性水平。
埃塞俄比亚女性中的艾滋病毒血清阳性率呈非随机分布（全局 Moran's I = 0.16，p 值<0.001，Z 得分= 7.12）。在亚的斯亚贝巴、哈拉里、德雷达瓦和甘贝拉地区发现了艾滋病毒血清阳性率的显著热点聚类。较差的财富指数、离婚和丧偶、有多个性伴侣以及初次性经历较早（<15 岁）被发现是女性中艾滋病毒血清阳性率的地理变化的预测因素。
埃塞俄比亚女性中的艾滋病毒血清阳性率存在地域差异。因此，建议在高热点地区部署更多资源。应该制定方案，重点增强妇女的经济权能，以防止她们从事危险的性行为。此外，在学校和社区环境中开展关于初次性经历过早的后果的全面性教育方案，可能在降低埃塞俄比亚女性中的艾滋病毒血清阳性率方面发挥作用。
