Mapping the spatial disparities of HIV prevalence in Ethiopian zones using the generalized additive model

Abstract

HIV is a worldwide social and health pandemic that poses a significant problem. This study contributes to the 2030 global agenda of reducing HIV prevalence. The study analyzed HIV prevalence using the 2016 Ethiopian Demographic and Health Survey data. The study included men aged 15-54 years and women aged 15-49 years who responded to questions about HIV tests. A generalized geo-additive model (GAM) was fitted to HIV data using nonparametric smooth terms for geolocations. Two smoothing techniques were used in GAMs to evaluate spatial disparities and the probable effects of variables on HIV risk. There were certain areas in Ethiopia that were identified as hot spot zones for HIV, including Nuer and Agnuak in Gambella, West Wollega and Illubabor in Oromia, Benchi Maji and Shaka in SNNPR, Awsi, Fantana, Kilbet, and Gabi in the Afar region, Shinilie of the Somalia region, North and South Wollo, Oromia special zones of the Amhara region, Central Ethiopia, and Addis Ababa city. On the other hand, the eastern parts of Ethiopia, particularly most zones in the Somalia region, were identified as cold spot zones with the lowest HIV odds ratio. The odds of HIV+ were higher for those who reside in rural areas than in urban areas. Furthermore, people who have STIs, who used contraceptive methods, and who learned at the secondary level of education were more likely to be infected with HIV. After adjusting for confounding variables, the results indicated that there are substantially significant spatial variations in HIV prevalence across Ethiopian zones. These results provide essential information to strategically target geographic areas to allocate resources and policy interventions at zonal level administrations.