Spatial analysis of HIV infection and associated individual characteristics in Burundi: indications for effective prevention

摘要

Adequate resource allocation is critical in the battle against HIV/AIDS, especially in Africa. The determination of the location and nature of HIV services to implement must comply with the geographic, social and behavioral characteristics of patients. We therefore investigated the spatial heterogeneity of HIV prevalence in Burundi and then assessed the association of social and behavioral characteristics with HIV infection accounting for the spatial heterogeneity. We used data from the 2010 Demographic and Health Survey. We analyzed these data with a geostatistical approach (which takes into account spatial autocorrelation) by i) interpolating HIV data using the kernel density estimation, ii) identifying the spatial clusters with high and low HIV prevalence using the Kulldorff spatial scan statistics, and then iii) performing a multivariate spatial logistic regression. Overall HIV prevalence was 1.4?%. The interpolated data showed the great spatial heterogeneity of HIV prevalence (from 0 to 10?%), independently of administrative boundaries. A cluster with high HIV prevalence was found in the capital city and adjacent areas (3.9?%; relative risk 3.7, p?