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Spatial modeling of HIV prevalence in Malawi using generalized additive models
Zacharie Tsala Dimbuene1, Crispin Mabika Mabika2, Blandine Bawawana Bavwidinsi2
1School of Population and Development Sciences, University of Kinshasa, Kinshasa, Democratic Republic of Congo.
Frontiers in Epidemiology
|July 23, 2026
Summary
HIV prevalence in Malawi shows significant geographic disparities, particularly in the south. Sociodemographic factors are key drivers, necessitating tailored interventions for effective HIV prevention and treatment across districts.
Area of Science:
- Epidemiology
- Public Health
- Spatial Analysis
Background:
- Malawi has achieved progress in HIV prevention and treatment.
- HIV prevalence varies significantly across the country, requiring sub-national data for targeted interventions.
Purpose of the Study:
- To provide sub-national estimates of HIV prevalence in Malawi.
- To identify geographic and sociodemographic determinants of HIV distribution.
- To generate high-resolution maps for visualizing fine-scale prevalence differences.
Main Methods:
- Analysis of individual-level HIV biomarker data from the 2016 Malawi Demographic and Health Survey.
- Application of a spatial modeling approach to analyze geographic patterns and sociodemographic factors.
- Generation of high-resolution maps predicting HIV prevalence at the district level.
Main Results:
- Persistent geographic disparities in HIV prevalence were observed, with higher concentrations in southern Malawi.
- Sociodemographic factors (age, education, sex, household characteristics) were primary drivers of HIV variation in most districts.
- Geography was the leading contributor to HIV prevalence in only 18% of areas.
Conclusions:
- Sub-national evidence is crucial for precise targeting of HIV prevention, testing, and treatment efforts.
- Tailoring interventions to both geographic and sociodemographic contexts is essential for accelerating HIV epidemic control in Malawi.
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