Chireshe Exaverio, Chifurira Retius, Chinhamu Knowledge, Batidzirai Jesca Mercy, Kharsany Ayesha B M
School of Mathematics, Statistics and Computer Science, College of Agriculture, Engineering and Science, University of KwaZulu-Natal, Durban 4001, South Africa.
Centre for the AIDS Programme of Research in South Africa (CAPRISA), Doris-Duke Medical Research Institute, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban 4001, South Africa.
Int J Environ Res Public Health. 2025 Mar 17;22(3):446. doi: 10.3390/ijerph22030446.
HIV remains a major public health challenge in sub-Saharan Africa, with South Africa bearing the highest burden. This study confirms that KwaZulu-Natal (KZN) is a hotspot, with a high HIV prevalence of 47.4% (95% CI: 45.7-49.1) among females aged 15-34. We investigated the spatial distribution and key socio-demographic, behavioural, and economic factors associated with HIV prevalence in this group using a Bayesian spatial logistic regression model. Secondary data from 3324 females in the HIV Incidence Provincial Surveillance System (HIPSS) (2014-2015) in uMgungundlovu District, KZN, were analysed. Bayesian spatial models fitted using the Integrated Nested Laplace Approximation (INLA) identified key predictors and spatial clusters of HIV prevalence. The results showed that age, education, marital status, income, alcohol use, condom use, and number of sexual partners significantly influenced HIV prevalence. Older age groups (20-34 years), alcohol use, multiple partners, and STI/TB diagnosis increased HIV risk, while tertiary education and condom use were protective. Two HIV hotspots were identified, with one near Greater Edendale being statistically significant. The findings highlight the need for targeted, context-specific interventions to reduce HIV transmission among young females in KZN.
在撒哈拉以南非洲，艾滋病毒仍然是一项重大的公共卫生挑战，南非承受着最重的负担。本研究证实，夸祖鲁-纳塔尔省（KZN）是一个热点地区，15至34岁女性中的艾滋病毒流行率高达47.4%（95%置信区间：45.7 - 49.1）。我们使用贝叶斯空间逻辑回归模型调查了该群体中与艾滋病毒流行率相关的空间分布以及关键的社会人口统计学、行为和经济因素。对来自KZN省乌姆贡古德洛武区艾滋病毒发病率省级监测系统（HIPSS）（2014 - 2015年）的3324名女性的二手数据进行了分析。使用集成嵌套拉普拉斯近似法（INLA）拟合的贝叶斯空间模型确定了艾滋病毒流行率的关键预测因素和空间聚集区。结果表明，年龄、教育程度、婚姻状况、收入、饮酒情况、使用安全套情况以及性伴侣数量对艾滋病毒流行率有显著影响。年龄较大的群体（20 - 34岁）、饮酒、多个性伴侣以及性传播感染/结核病诊断增加了感染艾滋病毒的风险，而高等教育和使用安全套则具有保护作用。确定了两个艾滋病毒热点地区，其中一个靠近大伊登代尔，具有统计学意义。研究结果凸显了需要采取有针对性的、因地制宜的干预措施，以减少KZN省年轻女性中的艾滋病毒传播。
