Abstract
IntroductionWithin many sub‐Saharan African countries including Malawi, HIV prevalence varies widely between regions. This variability may be related to the distribution of population groups with specific sociobehavioural characteristics that influence the transmission of HIV and the uptake of prevention. In this study, we intended to identify groups of people in Malawi with similar risk profiles.MethodsWe used data from the Demographic and Health Survey in Malawi (2015 to 2016), and stratified the analysis by sex. We considered demographic, socio‐behavioural and HIV‐related variables. Using Latent Class Analysis (LCA), we identified groups of people sharing common sociobehavioural characteristics. The optimal number of classes (groups) was selected based on the Bayesian information criterion. We compared the proportions of individuals belonging to the different groups across the three regions and 28 districts of Malawi.ResultsWe found nine groups of women and six groups of men. Most women in the groups with highest risk of being HIV positive were living in female‐headed households and were formerly married or in a union. Among men, older men had the highest risk of being HIV positive, followed by young (20 to 25) single men. Generally, low HIV testing uptake correlated with lower risk of having HIV. However, rural adolescent girls had a low probability of being tested (48.7%) despite a relatively high HIV prevalence. Urban districts and the Southern region had a higher percentage of high‐prevalence and less tested groups of individuals than other areas.ConclusionsLCA is an efficient method to find groups of people sharing common HIV risk profiles, identify particularly vulnerable sub‐populations, and plan targeted interventions focusing on these groups. Tailored support, prevention and HIV testing programmes should focus particularly on female household heads, adolescent girls living in rural areas, older married men and young men who have never been married.
Highlights
Within many sub-Saharan African countries including Malawi, HIV prevalence varies widely between regions.This variability may be related to the distribution of population groups with specific sociobehavioural characteristics that influ-ence the transmission of HIV and the uptake of prevention
Our finding agrees with a recent study, which reported a regional variance of HIV testing uptake in Malawi, with a better testing uptake in the North, this study focused on men [25]
Our findings can help focusing on evidence-based interventions for maximum impact and improve targeting of critical interventions to key and vulnerable population as advocated in the National Strategic Plan for HIV and AIDS [40]
Summary
Within many sub-Saharan African countries including Malawi, HIV prevalence varies widely between regions This variability may be related to the distribution of population groups with specific sociobehavioural characteristics that influence the transmission of HIV and the uptake of prevention. Conclusions: LCA is an efficient method to find groups of people sharing common HIV risk profiles, identify vulnerable sub-populations, and plan targeted interventions focusing on these groups. Key national policies include active index testing, HIV self-testing, ART optimization and annual viral load testing in combination with a data monitoring system to track the effectiveness of interventions [2] Despite this progress, disparities between region and populations remain and interventions that better target those who are most at risk are needed to control the epidemic
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