Gedefie Alemu, Muche Amare, Mohammed Anissa, Ayres Aznamariam, Melak Dagnachew, Abeje Eyob Tilahun, Bayou Fekade Demeke, Belege Getaneh Fekadeselassie, Asmare Lakew, Endawkie Abel
Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
Front Public Health. 2025 Jan 24;12:1376235. doi: 10.3389/fpubh.2024.1376235. eCollection 2024.
Human immunodeficiency virus (HIV) remains the leading cause of global morbidity and mortality. The incidence of HIV is disproportionately higher in Sub-Saharan regions, particularly the Southern African sub-region, which is the most affected region and accounts for 77% of all new HIV infections in the region. Thus, the aim of this study was to identify the determinants of HIV among reproductive-age women in Africa.
This study was conducted among reproductive-age women in Africa, based on secondary data obtained from the Demographic Health Survey (DHS) conducted between 2010 and 2019. The outcome variable was HIV status, while individual- and community-level variables served as potential predictors. The model fit was assessed using Akaike's Information Criterion, Bayesian Information Criterion, and - 2 Log likelihood. Then, multilevel mixed-effects analysis was used. Intra-cluster correlation coefficient, median odds ratio, and proportional change in variance were used to measure heterogeneity between clusters.
A total of 292,810 unweighted and 293,773 weighted reproductive-age women in 26 African nations were included in this study. The overall prevalence of HIV among reproductive-age women in Africa was 4.34% (95% CI: 4.2, 4.4%). The highest percentage of HIV was found in Lesotho (23.98%), followed by South Africa (19.12%), and Mozambique (14.67%). However, the lowest HIV prevalence was found in Niger (0.54%), Senegal (0.59%), and Burundi (0.79%). Southern Africa has the highest HIV burden (18.5%), followed by Eastern Africa (6.1%), while Western African countries have the lowest HIV burden. Increasing maternal age, higher maternal education, women who were unemployed, a history of multiple sexual partners, women in a union, community-level educational status, community-level wealth index, African sub-region, and urban residence were found to be independent predictors of HIV infection in Africa.
The burden of HIV has remained higher, highlighting the need for targeted public health intervention strategies to prevent the transmission of HIV among key populations.
人类免疫缺陷病毒（HIV）仍然是全球发病和死亡的主要原因。撒哈拉以南地区，尤其是南部非洲次区域的HIV发病率高得不成比例，该地区是受影响最严重的地区，占该地区所有新HIV感染病例的77%。因此，本研究的目的是确定非洲育龄妇女中HIV的决定因素。
本研究基于2010年至2019年期间进行的人口与健康调查（DHS）获得的二手数据，在非洲育龄妇女中开展。结果变量是HIV感染状况，而个体和社区层面的变量作为潜在预测因素。使用赤池信息准则、贝叶斯信息准则和-2对数似然评估模型拟合情况。然后，采用多水平混合效应分析。使用组内相关系数、中位数优势比和方差比例变化来衡量组间异质性。
本研究纳入了26个非洲国家的292,810名未加权和293,773名加权育龄妇女。非洲育龄妇女中HIV的总体患病率为4.34%（95%置信区间：4.2, 4.4%）。HIV感染率最高的是莱索托（23.98%），其次是南非（19.12%）和莫桑比克（14.67%）。然而，HIV感染率最低的是尼日尔（0.54%）、塞内加尔（0.59%）和布隆迪（0.79%）。南部非洲的HIV负担最高（18.5%），其次是东非（6.1%），而西非国家的HIV负担最低。母亲年龄增加、母亲教育程度较高、失业妇女、有多个性伴侣史、处于婚姻关系中的妇女、社区层面的教育状况、社区层面的财富指数、非洲次区域和城市居住情况被发现是非洲HIV感染的独立预测因素。
HIV负担仍然较高，这凸显了需要有针对性的公共卫生干预策略来预防HIV在重点人群中的传播。
