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Estimating district HIV prevalence in Zambia using small-area estimation methods (SAE).
Chris Mweemba1, Peter Hangoma2, Isaac Fwemba2,3
1Department of Health Policy, Systems and Management, School of Public Health, University of Zambia, Ridgeway Campus, P.O. Box 50110, Lusaka, Zambia. chris.muna@gmail.com.
Population Health Metrics
|February 20, 2022
Summary
This study mapped HIV prevalence across Zambian districts, revealing significant variations. Targeted HIV resource allocation is crucial, especially in high-prevalence border and transit areas.
Area of Science:
- Epidemiology
- Public Health
- Biostatistics
Background:
- The HIV/AIDS pandemic disproportionately affects Eastern and Southern Africa.
- Geographical variations in HIV prevalence necessitate tailored interventions.
- District-level HIV burden data are crucial for effective resource allocation but are often lacking.
Purpose of the Study:
- To estimate district-level HIV prevalence in Zambia.
- To inform targeted HIV resource allocation and planning.
- To address geographical disparities in the HIV/AIDS pandemic.
Main Methods:
- Utilized Small-Area Estimation (SAE) techniques.
- Employed data from the 2016 Zambia Population-Based HIV Impact Assessment Survey (ZAMPHIA).
- Integrated auxiliary data from the 2010 Zambian Census and antenatal care sentinel surveillance, using Fay-Herriot models in R Programming.
Main Results:
- District HIV prevalence varied widely, from 4.2% to 23.5%.
- 32% of districts exceeded the national HIV prevalence average.
- High prevalence rates were observed in some rural districts and those near international borders or transit routes.
Conclusions:
- Significant geographical variations in HIV prevalence exist across Zambian districts.
- A differentiated approach to HIV programming is essential for Zambia.
- Prioritizing HIV resources towards districts with high population mobility is recommended.
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