Spatial heterogeneity in relationship between district patterns of HIV incidence and covariates in Zimbabwe: a multi-scale geographically weighted regression analysis

Submitted: 2 May 2023
Accepted: 28 August 2023
Published: 27 November 2023
Abstract Views: 1024
PDF: 448
HTML: 29
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

A study was conducted to investigate the district-level patterns of incidence of the human immunodeficiency virus (HIV) in Zimbabwe in the period 2005-2015 and explore variations in the relationship between covariates and HIV incidence across different districts. Demographic health survey data were analysed using hotspot analysis, spatial autocorrelation, and multi-scale geographically weighted regression (MGWR) techniques. The analysis revealed hotspots of the HIV epidemic in the southern and western regions of Zimbabwe in contrast to the eastern and northern regions. Specific districts in Matabeleland South and Matabeleland North provinces showed clusters of HIV incidence in 2005-2006, 2010-2011 and 2015. Variables studied were multiple sex partners and sexually transmitted infections (STI) condom use and being married. Recommendations include implementing targeted HIV prevention programmes in identified hotspots, prioritising interventions addressing the factors mentioned above as well as enhancing access to HIV testing and treatment services in high-risk areas, strengthening surveillance systems, and conducting further research to tailor interventions based on contextual factors. The study also emphasizes the need for regular monitoring and evaluation at the district level to inform effective responses to the HIV epidemic over time. By addressing the unique challenges and risk factors in different districts, significant progress can be made in reducing HIV transmission and improving health outcomes in Zimbabwe. These findings should be valuable for policymakers in resource allocation and designing evidence-based interventions.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Ahmad I, Dar MA, Fenta A, Halefom A, Nega H, Andualem TG, Teshome A. 2021. Spatial Configuration Of Groundwater Potential Zones Using Ols Regression Method. J Afr Earth Sci 177;104147. DOI: https://doi.org/10.1016/j.jafrearsci.2021.104147
Anselin L, 1995. Local Indicators Of Spatial Association—Lisa. Geograph Anal 27;93-115. DOI: https://doi.org/10.1111/j.1538-4632.1995.tb00338.x
Anselin L, Lozano N, Koschinsky J. 2006. Rate Transformations And Smoothing. Urbana, 51, 61801.
Aswi A, Cramb S, Duncan E, Mengersen K. 2021. Detecting Spatial Autocorrelation For A Small Number Of Areas: A Practical Example. J Physics: Conference Series, 2021;012098. DOI: https://doi.org/10.1088/1742-6596/1899/1/012098
Aturinde A, Farnaghi M, Pilesjö P, Mansourian A, 2019. Spatial Analysis Of Hiv-Tb Co-Clustering In Uganda. Bmc Infect Dis 19;1-10. DOI: https://doi.org/10.1186/s12879-019-4246-2
Awaidy SA, Ghazy RM, Mahomed O. 2023. Progress Of The Gulf Cooperation Council (Gcc) Countries Towards Achieving The 95-95-95 Unaids Targets: A Review. J Epidemiol Global Health, 1-10. DOI: https://doi.org/10.1007/s44197-023-00097-1
Birri Makota R, Musenge E, 2019. Factors Associated With HIV Infection In Zimbabwe Over A Decade From 2005 To 2015: An Interval-Censoring Survival Analysis Approach. Front Public Health 7;262. DOI: https://doi.org/10.3389/fpubh.2019.00262
Birri Makota R, Musenge E, 2022. Estimating Age Specific Prevalence And Force Of Infection In Zimbabwe Using Combined Cross-Sectional Surveys From 2005-2015. Front Epidemiol 2;59. DOI: https://doi.org/10.3389/fepid.2022.1029583
Bulstra CA, Hontelez JA, Giardina F, Steen R, Nagelkerke NJ, Bärnighausen T, De Vlas SJ, 2020. Mapping And Characterising Areas With High Levels Of HIV Transmission In Sub-Saharan Africa: A Geospatial Analysis Of National Survey Data. Plos Medicine 17:E1003042. DOI: https://doi.org/10.1371/journal.pmed.1003042
Coburn BJ, Okano JT, Blower S, 2013. Current Drivers And Geographic Patterns Of Hiv In Lesotho: Implications For Treatment And Prevention In Sub-Saharan Africa. BMC Medicine 11;1-11. DOI: https://doi.org/10.1186/1741-7015-11-224
Cuadros DF, Li J, Branscum AJ, Akullian A, Jia P, Mziray EN, Tanser F, 2017. Mapping The Spatial Variability Of Hiv Infection In Sub-Saharan Africa: Effective Information For Localized HIV Prevention And Control. Sci Rep 7;9093. DOI: https://doi.org/10.1038/s41598-017-09464-y
Cuadros DF, Li J, Mukandavire Z, Musuka GN, Branscum AJ, Sartorius B, Mugurungi O, Tanser F, 2019. Towards Unaids Fast-Track Goals: Targeting Priority Geographic Areas For HIV Prevention And Care In Zimbabwe. AIDS 33;305-314. DOI: https://doi.org/10.1097/QAD.0000000000002052
Dwyer-Lindgren L, Cork MA, Sligar A, Steuben KM, Wilson KF, Provost NR, Mayala BK, Vanderheide JD, Collison ML, Hall JB, Biehl MH, Carter A, Frank T, Douwes-Schultz D, Burstein R, Casey DC, Deshpande A, Earl L, El Bcheraoui C, Farag TH, Henry NJ, Kinyoki D, Marczak LB, Nixon MR, Osgood-Zimmerman A, Pigott D, Reiner RC, Ross JM, Schaeffer LE, Smith DL, Davis Weaver N, Wiens KE, Eaton JW, Justman JE, Opio A, Sartorius B, Tanser F, Wabiri N, Piot P, Murray CJL, Hay SI, 2019. Mapping HIV Prevalence In Sub-Saharan Africa Between 2000 And 2017. Nature 570;189-193. DOI: https://doi.org/10.1038/s41586-019-1200-9
ESRI 2023. Arcgis Pro. 3.1 Ed. Redlands, Ca: Environmental Systems Research Institute.
Fotheringham AS, Yang W, Kang W, 2017. Multiscale Geographically Weighted Regression (Mgwr). Ann Am Ass Geograph 107;1247-1265. DOI: https://doi.org/10.1080/24694452.2017.1352480
Fox AM, 2012. The HIV–Poverty Thesis Re-Examined: Poverty, Wealth Or Inequality As A Social Determinant Of HIV Infection In Sub-Saharan Africa? J Biosoc Sci 44;459-480. DOI: https://doi.org/10.1017/S0021932011000745
Gaumer G, Sherafat-Kazemzadeh R, Jordan M, Nandakumar A, 2021. Wealth And Wealth Inequality In Adult HIV Prevalence. J Global Health Rep 4;E2020105. DOI: https://doi.org/10.29392/001c.18126
Gonese E, Musuka G, Ruangtragool L, Hakim A, Parekh B, Dobbs T, Duong YT, Patel H, Mhangara M, Mugurungi O. 2020. Comparison Of HIV Incidence In The Zimbabwe Population-Based HIV Impact Assessment Survey (2015–2016) With Modeled Estimates: Progress Toward Epidemic Control. AIDS Res Human Retrovir 36;656-662. DOI: https://doi.org/10.1089/aid.2020.0046
Gribov A, Krivoruchko K. 2020. Empirical Bayesian Kriging Implementation And Usage. Sci Total Environ 722;137290. DOI: https://doi.org/10.1016/j.scitotenv.2020.137290
Gwitira I, Murwira A, Mberikunashe J, Masocha M, 2018. Spatial Overlaps In The Distribution Of Hiv/Aids And Malaria In Zimbabwe. BMC Infect Dis 18;1-10. DOI: https://doi.org/10.1186/s12879-018-3513-y
Hashim H, Wan Mohd W, Sadek E, Dimyati K. 2019. Modeling Urban Crime Patterns Using Spatial Space Time And Regression Analysis. Int Arch Photogrammetry Remote Sensing Spatial Inform Sci 42;247-254. DOI: https://doi.org/10.5194/isprs-archives-XLII-4-W16-247-2019
Huang J, Mao X, Deng H, Liu Z, Chen J, Xiao K, 2022. An Improved Gwr Approach For Exploring The Anisotropic Influence Of Ore-Controlling Factors On Mineralization In 3d Space. Nat Resour Res 1-16. DOI: https://doi.org/10.1007/s11053-022-10112-0
Jahagirdar D, Walters MK, Novotney A, Brewer ED, Frank TD, Carter A, Biehl MH, Abbastabar H, Abhilash E, Abu-Gharbieh E, 2021. Global, Regional, And National Sex-Specific Burden And Control Of The Hiv Epidemic, 1990–2019, For 204 Countries And Territories: The Global Burden Of Diseases Study 2019. Lancet HIV 8;E633-E651.
Kharsany AB, Karim QA, 2016. Hiv Infection And Aids In Sub-Saharan Africa: Current Status, Challenges And Opportunities. Open Aids J 10;34. DOI: https://doi.org/10.2174/1874613601610010034
Leclerc-Madlala S. 2008. Age-Disparate And Intergenerational Sex In Southern Africa: The Dynamics Of Hypervulnerability. AIDS 22;S17-S25. DOI: https://doi.org/10.1097/01.aids.0000341774.86500.53
Lumbidzani D. 2022. Why Tsholotsho Has The Highest HIV Burden. Chronicles, 21 March 2022. Available from: https://www.chronicle.co.zw/why-tsholotsho-has-highest-hiv-burden/
Mabaso M, Mlangeni L, Makola L, Oladimeji O, Naidoo I, Naidoo Y, Chibi B, Zuma K, Simbayi, L, 2021. Factors Associated With Age-Disparate Sexual Partnerships Among Males And Females In South Africa: A Multinomial Analysis Of The 2012 National Population-Based Household Survey Data. Emerging Themes Epidemiol 18;3. DOI: https://doi.org/10.1186/s12982-021-00093-5
Makurumidze R, Decroo T, Lynen L, Chinwadzimba ZK, Van Damme W, Hakim J, Rusakaniko S, 2020. District-Level Strategies To Control The HIV Epidemic In Zimbabwe: A Practical Example Of Precision Public Health. BMC Res Notes 13;1-6. DOI: https://doi.org/10.1186/s13104-020-05234-8
Manepalli UR, Bham GH, Kandada S. Evaluation Of Hotspots Identification Using Kernel Density Estimation (K) And Getis-Ord (Gi*) On I-630. 3rd International Conference On Road Safety And Simulation, 2011; pp. 14-16.
Manyangadze T, Chimbari MJ, Mavhura E, 2021. Spatial Heterogeneity Association Of HIV Incidence With Socio-Economic Factors In Zimbabwe. J Geograph Res 4. DOI: https://doi.org/10.30564/jgr.v4i3.3466
Mishra V, Assche SBV, Greener R, Vaessen M, Hong R, Ghys PD, Boerma JT, Van Assche A, Khan S, Rutstein S, 2007. HIV Infection Does Not Disproportionately Affect The Poorer In Sub-Saharan Africa. AIDS 21;S17-S28. DOI: https://doi.org/10.1097/01.aids.0000300532.51860.2a
Mitchell, A. 1999. The ESRI Guide To Gis Analysis.
Moturi AK, Suiyanka L, Mumo E, Snow RW, Okiro EA, Macharia PM, 2022. Geographic Accessibility To Public And Private Health Facilities In Kenya In 2021: An Updated Geocoded Inventory And Spatial Analysis. Front Public Health 10;4245. DOI: https://doi.org/10.3389/fpubh.2022.1002975
Moyo N, Maharaj P, Mambondiani L, 2017. Food Challenges Facing People Living With HIV/AIDS In Zimbabwe. Afr J AIDS Res 16;225-230. DOI: https://doi.org/10.2989/16085906.2017.1362018
Oseni Z, Seedat F, Kandala NB, 2018. HIV Epidemic Heterogeneity In Zimbabwe: Evidence From Successive Demographic And Health Surveys. J Biosoc Sci 50;840-852. DOI: https://doi.org/10.1017/S0021932017000657
Oshan TM, Li Z, Kang W, Wolf LJ, Fotheringham AS, 2019. MGWR: A Python Implementation Of Multiscale Geographically Weighted Regression For Investigating Process Spatial Heterogeneity And Scale. ISPRS Int J Geo-Information 8;269. DOI: https://doi.org/10.3390/ijgi8060269
Patel CJ, Claypool KT, Chow E, Chung M-K, Mai D, Chen J, Bendavid E. 2022. The Demographic And Socioeconomic Correlates Of Behavior And HIV Infection Status Across Sub-Saharan Africa. Comm Med 2;104. DOI: https://doi.org/10.1038/s43856-022-00170-z
Schaefer R, Gregson S, Takaruza A, Rhead R, Masoka T, Schur N, Anderson SJ, Nyamukapa C, 2017. Spatial Patterns Of Hiv Prevalence And Service Use In East Zimbabwe: Implications For Future Targeting Of Interventions. J Int AIDS Soc 20;21409. DOI: https://doi.org/10.7448/IAS.20.1.21409
StataCorp. 2017. Stata 15 Base Reference Manual. College Station, Tx: Stata Press.
Wabiri N, Shisana O, Zuma K, Freeman J, 2016. Assessing The Spatial Nonstationarity In Relationship Between Local Patterns Of HIV Infections And The Covariates In South Africa: A Geographically Weighted Regression Analysis. Spatial Spatio-Temporal Epidemiol 16;88-99. DOI: https://doi.org/10.1016/j.sste.2015.12.003
Wheeler DC, Páez A. 2010. Geographically Weighted Regression. Handbook Of Applied Spatial Analysis. Springer. DOI: https://doi.org/10.1007/978-3-642-03647-7_22
Zimbabwe Central Statistical Office & Macro International 2007. Zimbabwe Demographic And Health Survey 2005-06. Calverton, Maryland, Usa: Central Statistical Office/Zimbabwe And Macro International.
Zimbabwe National Statistics Agency & Icf International 2016. Zimbabwe Demographic And Health Survey 2015: Final Report. Rockville, Maryland, Usa: Zimbabwe National Statistics Agency (Zimstat) And Icf International.
Zimbabwe National Statistics Agency - Zimstat & Icf International 2012. Zimbabwe Demographic And Health Survey 2010-11. Calverton, Maryland, Usa: Zimstat And Icf International.

How to Cite

Birri Makota, R., & Musenge, E. (2023). Spatial heterogeneity in relationship between district patterns of HIV incidence and covariates in Zimbabwe: a multi-scale geographically weighted regression analysis. Geospatial Health, 18(2). https://doi.org/10.4081/gh.2023.1207