Mapping the spatial variability of HIV infection in Sub-Saharan Africa

August 22, 2017

Abstract: 

HIV prevalence mapping
Under the premise that in a resource-constrained environment such as Sub-Saharan Africa it is not possible to do everything, to everyone, everywhere, detailed geographical knowledge about the HIV epidemic becomes essential to tailor programmatic responses to specific local needs. However, the design and evaluation of national HIV programs often rely on aggregated national level data. Against this background, here we proposed a model to produce high-resolution maps of intranational estimates of HIV prevalence in Kenya, Malawi, Mozambique and Tanzania based on spatial variables. The HIV prevalence maps generated highlight the stark spatial disparities in the epidemic within a country, and localize areas where both the burden and drivers of the HIV epidemic are concentrated. Under an era focused on optimal allocation of evidence-based interventions for populations at greatest risk in areas of greatest HIV burden, as proposed by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the United States President’s Emergency Plan for AIDS Relief (PEPFAR), such maps provide essential information that strategically targets geographic areas and populations where resources can achieve the greatest impact.

Fig. 2

High resolution maps for HIV prevalence in (A) Kenya; (B) Malawi; (C) Mozambique; and (D) Tanzania.

Results
Based on lack of spatial structure and/or statistical significance, condom use and distance to main roads were excluded from the final model for Kenya; condom use, lifetime number of sexual partners and HIV testing were excluded from the final model for Malawi; condom use, level of education, HIV testing, NDVI and distance to main roads were excluded from the final model in Mozambique; and HIV testing and NDVI were excluded from the final model for Tanzania.