Covariates and Spatial Interpolation of HIV Screening in Mozambique: Insight from the 2015 AIDS Indicator Survey.

Pascal Agbadi,Ernest Darkwah,Jerry John Nutor,Henry Ofori Duah,Robert Kaba Alhassan,Kimberly Baltzell,Precious Adade Duodu

doi:10.3390/ijerph17165630

Abstract

We examined the factors associated with human immunodeficiency virus (HIV) screening and developed a HIV screening prevalence surface map using spatial interpolation techniques to identify the geographical areas with the highest and lowest rates of HIV screening in Mozambique. We analyzed the cross-sectional 2015 Mozambique AIDS Indicator Surveys with an analytic sample of 12,995 participants. Analyses were conducted on SPSS-21, STATA-14, and R freeware 3.5.3. We adjusted for the sample design and population weights. Results indicated that 52.5% of Mozambicans had undergone HIV screening. Mozambicans with these characteristics have a higher probability of undergoing HIV screening: females, those with a primary education or higher, urban dwellers, residents of wealthy households, having at least one lifetime sexual partner, and dwelling in these provinces—Niassa, Tete, Manica, Sofala, Inhambane, Gaza, Maputo Provincia, and Maputo Cidade. The spatial map revealed that the national and regional estimates mask sub-regional level estimates. Generally, zones with the highest HIV screening prevalence are found in southern provinces while the lowest prevalence was found in the northern provinces. The map further revealed intraregional differences in HIV screening estimates. We recommend that HIV screening be expanded, with equitable screening resource allocations that target more nuanced areas within provinces which have a low HIV screening prevalence.

Highlights

Despite decades of global concerted efforts to combat the spread of human immunodeficiency virus (HIV) and mitigate its effects on the global population, HIV infections still rank among some of the most important public health concerns across the world
The results indicate that the effect of education on HIV testing is slightly bigger for men than for women, the relationship goes in the same direction (Table 4)
We found that a little over half (52.5%) of Mozambicans at reproductive age had undergone contributions have not been studied in Mozambique

Summary

Introduction

Despite decades of global concerted efforts to combat the spread of human immunodeficiency virus (HIV) and mitigate its effects on the global population, HIV infections still rank among some of the most important public health concerns across the world. According to the Joint United Nations Programme on HIV/AIDS (UNAIDS), an estimated 1.7 million new HIV infections were recorded worldwide in 2018 alone [1]. Epidemiological research shows the geographical and contextual differences in infection rates across different regions of the world, with countries in the global south being the most affected [2,3]. Sub-Saharan Africa has consistently topped the list of regions with the. Res. Public Health 2020, 17, 5630; doi:10.3390/ijerph17165630 www.mdpi.com/journal/ijerph

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