Payi Mzolisi Abednigo, Abaver Dominic, Apalata Teke
Faculty of Medicine and Health Sciences, Walter Sisulu University, South Africa.
Acta Psychol (Amst). 2025 May;255:104869. doi: 10.1016/j.actpsy.2025.104869. Epub 2025 Mar 14.
Sub-Saharan Africa faces a dual public health crisis of HIV and nutritional deficiencies driven by profound socio-economic disparities. Despite significant micro-study research, macro-level, longitudinal patterns and causal dynamics remain underexplored. This study employs Panel Auto-regressive distributed lags, Panel Granger causality, and Vector auto-correction model to examine the influence of social determinants on HIV prevalence and nutritional deficiencies across Sub-Saharan Africa. The study further carried out robustness diagnostics using Driscoll - Kraay standard error regression to confirm the reliability of the results. For HIV prevalence, income, education, and employment reduce rates over the long term, while healthcare access and housing quality show positive associations. Short-term effects show the benefits of income and healthcare access, with other factors showing limited impact. For nutritional deficiencies, income, education, employment, and housing quality significantly reduce malnutrition in the long term, while healthcare access correlates positively. Short-term effects show the immediate role of income and housing quality. The causal results show unidirectional links between income, education, employment, and housing quality to HIV. Housing quality and income exhibit bidirectional causality. No causal link exists between HIV and nutritional deficiencies. The study recommends the need for income support programs, expanded educational access, skill development, and strengthened healthcare systems.
撒哈拉以南非洲面临着由深刻的社会经济差距驱动的艾滋病毒和营养缺乏双重公共卫生危机。尽管有大量微观研究,但宏观层面的纵向模式和因果动态仍未得到充分探索。本研究采用面板自回归分布滞后模型、面板格兰杰因果检验和向量自校正模型,以检验社会决定因素对撒哈拉以南非洲艾滋病毒流行率和营养缺乏的影响。该研究还使用德里斯柯尔-克莱标准误差回归进行稳健性诊断,以确认结果的可靠性。对于艾滋病毒流行率,从长期来看,收入、教育和就业会降低感染率,而医疗保健可及性和住房质量则呈现正相关。短期影响显示了收入和医疗保健可及性的益处,其他因素的影响有限。对于营养缺乏,从长期来看,收入、教育、就业和住房质量会显著减少营养不良,而医疗保健可及性呈正相关。短期影响显示了收入和住房质量的直接作用。因果关系结果表明,收入、教育、就业和住房质量与艾滋病毒之间存在单向联系。住房质量和收入呈现双向因果关系。艾滋病毒与营养缺乏之间不存在因果联系。该研究建议需要实施收入支持计划、扩大教育机会、开展技能培训并加强医疗保健系统。