Spatial analysis of factors associated with HIV infection in Malawi: Indicators for effective prevention
Nutor, Jerry John, Duah, Henry Ofori, Agbadi, Pascal, Duodu, Precious Adade, and Gondwe, Kaboni W. (2020) Spatial analysis of factors associated with HIV infection in Malawi: Indicators for effective prevention. BMC Public Health, 20 (1). 1167.
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Abstract
Background: The objective of this study was to model the predictors of HIV prevalence in Malawi through a complex sample logistic regression and spatial mapping approach using the national Demographic and Health Survey datasets.
Methods: We conducted a secondary data analysis using the 2015–2016 Malawi Demographic and Health Survey and AIDS Indicator Survey. The analysis was performed in three stages while incorporating population survey sampling weights to: i) interpolate HIV data, ii) identify the spatial clusters with the high prevalence of HIV infection, and iii) perform a multivariate complex sample logistic regression.
Results: In all, 14,779 participants were included in the analysis with an overall HIV prevalence of 9% (7.0% in males and 10.8% in females). The highest prevalence was found in the southern region of Malawi (13.2%), and the spatial interpolation revealed that the HIV epidemic is worse at the south-eastern part of Malawi. The districts in the high HIV prevalent zone of Malawi are Thyolo, Zomba, Mulanje, Phalombe and Blantyre. In central and northern region, the district HIV prevalence map identified Lilongwe in the central region and Karonga in the northern region as districts that equally deserve attention. People residing in urban areas had a 2.2 times greater risk of being HIV-positive compared to their counterparts in the rural areas (AOR = 2.16; 95%CI = 1.57–2.97). Other independent predictors of HIV prevalence were gender, age, marital status, number of lifetime sexual partners, extramarital partners, the region of residence, condom use, history of STI in the last 12 months, and household wealth index. Disaggregated analysis showed in-depth sociodemographic regional variations in HIV prevalence.
Conclusion: These findings identify high-risk populations and regions to be targeted for Pre-Exposure Prophylaxis (PrEP) campaigns, HIV testing, treatment and education to decrease incidence, morbidity, and mortality related to HIV infection in Malawi.
| Item ID: | 88972 |
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| Item Type: | Article (Research - C1) |
| ISSN: | 1471-2458 |
| Keywords: | Gender, HIV, Pre-exposure prophylaxis, Risk behavior, Rural |
| Copyright Information: | © 2020 The Author(s). This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
| Date Deposited: | 26 Sep 2025 01:47 |
| FoR Codes: | 42 HEALTH SCIENCES > 4206 Public health > 420606 Social determinants of health @ 50% 44 HUMAN SOCIETY > 4409 Social work > 440999 Social work not elsewhere classified @ 50% |
| SEO Codes: | 20 HEALTH > 2004 Public health (excl. specific population health) > 200401 Behaviour and health @ 100% |
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