Geographic Variation in HIV Testing Among Transgender and Nonbinary Adults in the United States

Tordoff, Diana M.; Zangeneh, Sahar Z.; Khosropour, Christine M; Glick, Sara N.; McClelland, R. Scott; Dimitrov, Dobromir; Reisner, Sari L.; Duerr, Ann

doi:10.1097/qai.0000000000002909

Cited by 2 publications

(2 citation statements)

References 41 publications

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“…Premarital HIV testing was spatially clustered at the cluster level, and Getis-Ord spatial analysis revealed a significant hot and cold spots. Geographical variation in HIV testing has been reported by numerous studies conducted around the world [ 30 , 57 , 61 , 62 ]. This could be due to participant cultural, behavioral, and lifestyle variations among areas.…”

Section: Discussionmentioning

confidence: 99%

Spatial variation of premarital HIV testing and its associated factors among married women in Ethiopia: Multilevel and spatial analysis using 2016 demographic and health survey data

Tilahun,

Tesfie

2023

PLoS ONE

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Background Africa is the most severely affected area, accounting for more than two-thirds of the people living with HIV. In sub-Saharan Africa, more than 85% of new HIV-infected adolescents and 63% of all new HIV infections are accounted for by women. Ethiopia has achieved a 50% incidence rate reduction. However, mortality rate reduction is slow, as the estimated prevalence in 2021 is 0.8%. In sub-Saharan Africa, heterosexual transmission accounts for the majority of HIV infections, and women account for 58% of people living with HIV. Most of these transmissions took place during marriage. Thus, this study aimed to explore the spatial variation of premarital HIV testing across regions of Ethiopia and identify associated factors. Methods A cross-sectional study design was employed. A total of 10223 weighted samples were taken from individual datasets of the 2016 Ethiopian Demographic and Health Survey. STATA version 14 and ArcGIS version 10.8 software’s were used for analysis. A multilevel mixed-effect generalized linear model was fitted, and an adjusted prevalence Ratio with a 95% CI and p-value < 0.05 was used to declare significantly associated factors. Multilevel models were compared using information criteria and log-likelihood. Descriptive and spatial regression analyses (geographical weighted regression and ordinary least squares analysis) were conducted. Models were compared using AICc and adjusted R-squared. The local coefficients of spatial explanatory variables were mapped. Results In spatial regression analysis, secondary and above education level, richer and above wealth quintile, household media exposure, big problem of distance to health facility, having high risky sexual behaviour and knowing the place of HIV testing were significant explanatory variables for spatial variation of premarital HIV testing among married women. While in the multilevel analysis, age, education level, religion, household media exposure, wealth index, khat chewing, previous history of HIV testing,age at first sex, HIV related knowledge, HIV related stigma, distance to health facility, and community level media exposure were associated with premarital HIV testing among married women. Conclusions and recommendation Premarital HIV testing had a significant spatial variation across regions of Ethiopia. A statistically significant clustering of premarital HIV testing was observed at Addis Ababa, Dire Dawa, North Tigray and some parts of Afar and Amhara regions. Therefore area based prevention and interventional strategies are required at cold spot areas to halt the role of heterosexual transmission in HIV burden. Moreover, the considering the spatial explanatory variables effect in implementations of these strategies rather than random provision of service would make regional health care delivery systems more cost-effective.

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Section: Discussionmentioning

confidence: 99%

Spatial variation of premarital HIV testing and its associated factors among married women in Ethiopia: Multilevel and spatial analysis using 2016 demographic and health survey data

Tilahun,

Tesfie

2023

PLoS ONE

View full text Add to dashboard Cite

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“…( Parchem and Molock, 2022 , Zhang et al, 2021 , Wise et al, 2019 ) Other studies identified that demographic characteristics (e.g., age, sex, race/ethnicity, and educational status) might be associated with the HIV testing behaviors. ( Qiao et al, 2018 ) Much of the prior literature focused on HIV testing behaviors among specific populations, such as men who have sex with men, ( Bien-Gund et al, 2022 ) transgender, ( Tordoff et al, 2022 , Pitasi et al, 2020 ) Black racial groups, ( Uzoeghelu et al, 2021 ) youth, ( Haney-Caron et al, 2021 , Phillips et al, 2020 ) or populations from a specific region in the U.S. ( Marshall et al, 2020 , Daniel et al, 2022 ) In addition to these populations, prior studies also focused on people with mental illnesses like depression, demonstrating the potential influence of depression status on HIV testing. ( Senn and Carey, 2009 , Yehia et al, 2014 ) Our study adds to existing literature by focusing on a nationally representative sample of adults with self-reported depression across all demographic factors.…”

Section: Introductionmentioning

confidence: 99%