The relationship between development indicators and HIV epidemiology: a global perspective on social determinants

Area of Science:

• Global Health
• Epidemiology
• Socioeconomics

Background:

• Global HIV/AIDS epidemic persists despite prevention and treatment advances.
• Development imbalances and gender disparities significantly influence HIV burden.
• Existing research often overlooks the interplay between socioeconomic factors and HIV epidemiology.

Purpose of the Study:

• To investigate the association between key development indicators and HIV epidemiological measures.
• To analyze the relationship between Human Development Index (HDI), Gender Inequality Index (GII), Life Expectancy at Birth (LEaB), and Universal Health Coverage (UHC) with HIV incidence, prevalence, mortality, and ART coverage.

Main Methods:

• Utilized HIV-related data from the UNAIDS database for 2023.
• Included 129 countries with complete data, excluding those with missing information.
• Employed Spearman's correlation and univariable linear regression to analyze relationships between development indicators and HIV metrics.

Main Results:

• A significant positive correlation was found between GII and HIV incidence (r=0.53), prevalence (r=0.49), and mortality (r=0.64) (p<0.001).
• HDI, LEaB, and UHC showed inverse associations with all HIV epidemiological measures, most notably with mortality (HDI r=-0.65; LEaB r=-0.77; UHC r=-0.58).
• Sub-Saharan Africa exhibited the highest HIV burden, coinciding with low development levels, with notable disparities also in the Caribbean and Eastern Europe.

Conclusions:

• Lower HDI, higher GII, and shorter LEaB are strongly associated with a greater HIV burden.
• Findings underscore the critical need for region-specific, equity-driven strategies.
• Addressing gender inequality and improving healthcare access are crucial for mitigating the global HIV epidemic.