A decade of sustained geographic spread of HIV infections among women in Durban, South Africa
A decade of sustained geographic spread of HIV infections among women in Durban, South Africa
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DOI：
10.1186/s12879-019-4080-6
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发表时间：
2019-06-07
影响因子：
3.7
通讯作者：
Tanser, Frank
中科院分区：
文献类型：
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作者：
Ramjee, Gita;Sartorius, Benn;Tanser, Frank
背景精细尺度的艾滋病毒感染模式的地理空间分析可以用来促进地理上有针对性的干预措施。我们的目标是使用地理空间技术来映射的年龄和时间标准化的艾滋病毒的发病率在10 years的时间内，以确定社区在更大的艾滋病毒的高风险德班area.MethodsHIV的发病率从7557南非妇女参加了5个社区为基础的艾滋病毒预防试验（2002-2012年）被映射使用参与者家庭全球定位系统（GPS）坐标。年龄和时期标准化的艾滋病毒发病率计算了43个招聘集群在大德班。贝叶斯条件自回归面积空间回归（CAR）被用来确定显着的模式和聚集的新的HIV感染者在招聘community.ResultsThe队列中的总人次为9093.93年和613血清转换观察。所有社区的总体HIV粗发病率为674/100 PY（95% CI：622-730）。95%的集群的HIV发病率大于3/100 PY。CAR分析确定了六个艾滋病毒发病率极高的社区。这些集群的估计相对风险范围为1.34至1.70。与这些结果一致，年龄标准化HIV发病率在这些集群中也最高，估计为10/100 PY或以上。与35岁以上女性相比，年轻女性更可能居住在发病率最高的地区（aOR：151，95% CI：106-215; aOR：1.59，95% CI：119-214和aOR：162，95% CI：12-218，
BackgroundFine scale geospatial analysis of HIV infection patterns can be used to facilitate geographically targeted interventions. Our objective was to use the geospatial technology to map age and time standardized HIV incidence rates over a period of 10years to identify communities at high risk of HIV in the greater Durban area.MethodsHIV incidence rates from 7557 South African women enrolled in five community-based HIV prevention trials (2002-2012) were mapped using participant household global positioning system (GPS) coordinates. Age and period standardized HIV incidence rates were calculated for 43 recruitment clusters across greater Durban. Bayesian conditional autoregressive areal spatial regression (CAR) was used to identify significant patterns and clustering of new HIV infections in recruitment communities.ResultsThe total person-time in the cohort was 9093.93years and 613 seroconversions were observed. The overall crude HIV incidence rate across all communities was 674 per 100PY (95% CI: 622-730). 95% of the clusters had HIV incidence rates greater than 3 per 100PY. The CAR analysis identified six communities with significantly high HIV incidence. Estimated relative risks for these clusters ranged from 1.34 to 1.70. Consistent with these results, age standardized HIV incidence rates were also highest in these clusters and estimated to be 10 or more per 100 PY.Compared to women 35+ years old younger women were more likely to reside in the highest incidence areas (aOR: 151, 95% CI: 106-215; aOR: 1.59, 95% CI: 119-214 and aOR: 162, 95% CI: 12-218 for