Fornah Lovel, Shimbre Mulugeta Shegaze, Osborne Augustus, Ma Wei
Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, Jinan, Shandong, China.
Department of Public Health, Faculty of Health and Allied Sciences, Ernest Bai Koroma University of Science and Technology, Makeni, Northern, Sierra Leone.
BMJ Glob Health. 2025 Aug 5;10(8):e017208. doi: 10.1136/bmjgh-2024-017208.
Human immunodeficiency virus prevalence remains a major public health concern in Sierra Leone. This study examines the trends and spatial patterns of human immunodeficiency virus prevalence among men and women in Sierra Leone using data from the 2008, 2013, and 2019 Sierra Leone Demographic and Health Surveys (SLDHS).
We analyzed data from three SLDHS conducted in 2008, 2013, and 2019. Men and women aged 15-49 who tested for HIV were eligible. A trend analysis was used to examine the change in human immunodeficiency virus prevalence. Spatial autocorrelation and Moran's I statistic were used to assess the spatial distribution of human immunodeficiency virus prevalence. We used the 2019 SLDHS to determine the predictors of human immunodeficiency virus prevalence using geographically weighted regression.
The study found that human immunodeficiency virus prevalence was 1.5% in 2008, 1.3% in 2013 and 1.7% in 2019. From 2008 to 2019, human immunodeficiency virus prevalence in the Western and Northwest regions increased, with a consistent rise in the Southern region and an increase in the Northern regions. We identified hotspots for human immunodeficiency virus prevalence in Koinadugu, Kono, Bo and Kailahun districts. In 2008 and 2013, the Kono district had the highest human immunodeficiency virus prevalence, while the western areas, Port Loko and Bombali districts had the highest risk in 2019. Our geographically weighted regression analysis indicated that, age 15-19, urban residence and no formal education were predictors of HIV prevalence in 2019.
The human immunodeficiency virus prevalence across different districts is inconsistent, with Western areas having a higher prevalence while Southern and Northern regions showed varying trends. Hotspot regions were identified, with changes in high-risk areas over time. Predictors of human immunodeficiency virus prevalence in hotspot areas include age 15-19, urban residents and no formal education. The study suggests the need for prevention and intervention programmes for these high-risk areas and groups to reduce human immunodeficiency virus transmission in Sierra Leone.
在塞拉利昂，人类免疫缺陷病毒（HIV）的流行率仍然是一个主要的公共卫生问题。本研究利用2008年、2013年和2019年塞拉利昂人口与健康调查（SLDHS）的数据，考察了塞拉利昂男性和女性中HIV流行率的趋势和空间模式。
我们分析了2008年、2013年和2019年进行的三次SLDHS的数据。年龄在15 - 49岁且接受过HIV检测的男性和女性符合条件。采用趋势分析来考察HIV流行率的变化。利用空间自相关和莫兰指数（Moran's I）统计量来评估HIV流行率的空间分布。我们使用2019年SLDHS的数据，通过地理加权回归来确定HIV流行率的预测因素。
研究发现，2008年HIV流行率为1.5%，2013年为1.3%，2019年为1.7%。从2008年到2019年，西部地区和西北部地区的HIV流行率上升，南部地区持续上升，北部地区也有所增加。我们确定了科伊纳杜古、科诺、博城和凯拉洪等地区为HIV流行的热点地区。2008年和2013年，科诺地区的HIV流行率最高，而2019年西部地区、洛科港和邦巴利地区的风险最高。我们的地理加权回归分析表明，15 - 19岁、城市居住和未接受正规教育是2019年HIV流行率的预测因素。
不同地区的HIV流行率不一致，西部地区流行率较高，而南部和北部地区呈现不同趋势。确定了热点地区，且高风险地区随时间发生了变化。热点地区HIV流行率的预测因素包括15 - 19岁、城市居民和未接受正规教育。该研究表明，需要针对这些高风险地区和群体制定预防和干预计划，以减少塞拉利昂的HIV传播。
