title: Spatial and socio-behavioral patterns of HIV prevalence in the Democratic Republic of Congo.
abstract: This study uses a 2007 population-based household survey to examine the individual and community-level factors that increase an individual's risk for HIV infection in the Democratic Republic of Congo (DRC). Using the 2007 DRC Demographic Health Surveillance (DHS) Survey, we use spatial analytical methods to explore sub-regional patterns of HIV infection in the DRC. Geographic coordinates of survey communities are used to map prevalence of HIV infection and explore geographic variables related to HIV risk. Spatial cluster techniques are used to identify hotspots of infection. HIV prevalence is related to individual demographic characteristics and sexual behaviors and community-level factors. We found that the prevalence of HIV within 25 km of an individual's community is an important positive indicator of HIV infection. Distance from a city is negatively associated with HIV infection overall and for women in particular. This study highlights the importance of improved surveillance systems in the DRC and other African countries along with the use of spatial analytical methods to enhance understanding of the determinants of HIV infection and geographic patterns of prevalence, thereby contributing to improved allocation of public health resources in the future.
authors.affiliation: University of North Carolina, Department of Geography and Carolina Population Center, Chapel Hill, NC 27599-3220, USA.
authors.forename: Jane P
authors.initials: JP
authors.lastname: Messina
authors.forename: Michael
authors.initials: M
authors.lastname: Emch
authors.forename: Jeremie
authors.initials: J
authors.lastname: Muwonga
authors.forename: Kashamuka
authors.initials: K
authors.lastname: Mwandagalirwa
authors.forename: Samuel B
authors.initials: SB
authors.lastname: Edidi
authors.forename: Nicaise
authors.initials: N
authors.lastname: Mama
authors.forename: Augustin
authors.initials: A
authors.lastname: Okenge
authors.forename: Steven R
authors.initials: SR
authors.lastname: Meshnick
mesh_terms: D015023:Democratic Republic of the Congo / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D054624:Health Status Disparities; D006306:Health Surveys; D006801:Humans; D008297:Male; D011159:Population Surveillance / Q000379:methods*; D015995:Prevalence; D012111:Residence Characteristics; D012307:Risk Factors; D012737:Sex Factors; D012725:Sexual Behavior; D012959:Socioeconomic Factors; D013029:Space-Time Clustering