Osborne Augustus, Tejan Yusuf Sheku, Sesay Umaru, Kamara Ibrahim Franklyn
Institute for Development, Western Area, Freetown, Sierra Leone.
Ministry of Health, Western Area, Freetown, Sierra Leone.
BMC Public Health. 2025 Jul 29;25(1):2583. doi: 10.1186/s12889-025-23828-4.
Human immunodeficiency virus/acquired immune deficiency syndrome and sexually transmitted infections remain critical public health challenges in Sierra Leone, with major implications for morbidity and mortality. Understanding the trends in the prevalence of these infections and identifying sex-based disparities are essential for designing effective, evidence-based interventions. This study examined the trends in age-standardized prevalence of human immunodeficiency virus/acquired immune deficiency syndrome and sexually transmitted infections in Sierra Leone in 2000, 2005, 2010, 2015, and 2019.
A cross-sectional study design was conducted using age-standardized prevalence rates (per 100,000 population) of human immunodeficiency virus/acquired immune deficiency syndrome and sexually transmitted infections from the World Health Organization health equity assessment toolkit database at five time points (2000, 2005, 2010, 2015, and 2019). Inequality measures, including Difference (D), Ratio (R), Population Attributable Fraction (PAF), and Population Attributable Risk (PAR), were calculated to assess absolute and relative disparities between sexes. Confidence intervals (CI) were reported for all estimates to ensure robustness of results.
The age-standardized prevalence of human immunodeficiency virus/acquired immune deficiency syndrome and sexually transmitted infections in Sierra Leone showed a steady decline, from 25,995.3 per 100,000 population in 2000 to 25,705.5 in 2019. However, sex-disaggregated analysis revealed disparities, with females consistently experiencing higher prevalence rates than males across all years. In 2019, the prevalence for females was 34,548.5 per 100,000 population (95% CI: 30,887.3-38,496.7), compared to 16,734.0 per 100,000 population for males (95% CI: 14,674.0-19,020.4). The inequality ratio remained constant at 2.1, indicating that females consistently bore more than twice the burden compared to males. The absolute difference between sexes decreased slightly over time, from 17,962.9 per 100,000 population in 2000 to 17,814.5 per 100,000 population in 2019.
Despite the decline in the prevalence of human immunodeficiency virus/acquired immune deficiency syndrome and sexually transmitted infections in Sierra Leone between 2000 to 2019, sex-based disparities remain substantial, with females consistently experiencing a higher burden than males. These findings underscore the need for sex-sensitive policies and interventions to address the causes of these disparities. Strengthening health systems, promoting gender equity, and implementing targeted prevention programs are essential to reducing the overall prevalence and achieving health equity in Sierra Leone.
人类免疫缺陷病毒/获得性免疫缺陷综合征（HIV/AIDS）和性传播感染仍是塞拉利昂严峻的公共卫生挑战，对发病率和死亡率有重大影响。了解这些感染的流行趋势并确定基于性别的差异对于设计有效的循证干预措施至关重要。本研究调查了2000年、2005年、2010年、2015年和2019年塞拉利昂HIV/AIDS和性传播感染的年龄标准化患病率趋势。
采用横断面研究设计，使用世界卫生组织健康公平评估工具包数据库中五个时间点（2000年、2005年、2010年、2015年和2019年）的HIV/AIDS和性传播感染年龄标准化患病率（每10万人口）。计算不平等指标，包括差值（D）、比值（R）、人群归因分数（PAF）和人群归因风险（PAR），以评估性别之间的绝对和相对差异。报告所有估计值的置信区间（CI）以确保结果的稳健性。
塞拉利昂HIV/AIDS和性传播感染的年龄标准化患病率呈稳步下降趋势，从2000年的每10万人口25995.3例降至2019年的25705.5例。然而，按性别分类的分析显示存在差异，所有年份中女性的患病率始终高于男性。2019年，女性患病率为每10万人口34548.5例（95%CI：30887.3 - 38496.7），而男性为每10万人口16734.0例（95%CI：14674.0 - 19020.4）。不平等比值保持在2.1不变，表明女性负担始终是男性的两倍多。随着时间推移，性别之间的绝对差异略有下降，从2000年的每10万人口17962.9例降至2019年的每10万人口17814.5例。
尽管2000年至2019年塞拉利昂HIV/AIDS和性传播感染的患病率有所下降，但基于性别的差异仍然很大，女性负担始终高于男性。这些发现强调需要制定对性别敏感的政策和干预措施来解决这些差异的成因。加强卫生系统、促进性别平等以及实施有针对性的预防项目对于降低总体患病率和在塞拉利昂实现卫生公平至关重要。
