title: Assessing spatial patterns of HIV knowledge in rural Mozambique using geographic information systems.
abstract: OBJECTIVE
  To conduct a cross-sectional mapping analysis of HIV knowledge in Zambézia Province, Mozambique, and to examine spatial patterns of HIV knowledge and associated household characteristics.
  
  
  METHODS
  A population-based cluster survey was administered in 2010; data were analysed from 201 enumeration areas in three geographically diverse districts: Alto Molócuè, Morrumbala and Namacurra. We assessed HIV knowledge scores (0-9 points) using previously validated assessment tools. Using geographic information systems (GIS), we mapped hot spots of high and low HIV knowledge. Our multivariable linear regression model estimated HIV knowledge associations with distance to nearest clinic offering antiretroviral therapy, respondent age, education, household size, number of children under five, numeracy, literacy and district of residence.
  
  
  RESULTS
  We found little overall HIV knowledge in all three districts. People in Alto Molócuè knew comparatively most about HIV, with a median score of 3 (IQR 2-5) and 22 of 51 (43%) enumeration areas scoring ≥4 of 9 points. Namacurra district, closest to the capital city and expected to have the best HIV knowledge levels, had a median score of 1 (IQR 0-3) and only 3 of 57 (5%) enumeration areas scoring ≥4 points. More HIV knowledge was associated with more education, age, household size, numeracy and proximity to a health facility offering antiretroviral therapy.
  
  
  CONCLUSIONS
  HIV knowledge is critical for its prevention and treatment. By pinpointing areas of poor HIV knowledge, programme planners can prioritize educational resources and outreach initiatives within the context of antiretroviral therapy expansion.
authors.affiliation: Vanderbilt Institute for Global Health, Nashville, TN, USA.
authors.forename: Charlotte P
authors.initials: CP
authors.lastname: Buehler
authors.forename: Meridith
authors.initials: M
authors.lastname: Blevins
authors.forename: Ezequiel B
authors.initials: EB
authors.lastname: Ossemane
authors.forename: Lázaro
authors.initials: L
authors.lastname: González-Calvo
authors.forename: Elisée
authors.initials: E
authors.lastname: Ndatimana
authors.forename: Sten H
authors.initials: SH
authors.lastname: Vermund
authors.forename: Mohsin
authors.initials: M
authors.lastname: Sidat
authors.forename: Omo
authors.initials: O
authors.lastname: Olupona
authors.forename: Troy D
authors.initials: TD
authors.lastname: Moon
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005191:Family Characteristics; D005260:Female; D062305:Geographic Mapping; D015658:HIV Infections; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009073:Mozambique; D012044:Regression Analysis; D012424:Rural Population / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Analyse des zones sensibles; Análisis de puntos calientes; Conocimientos sobre VIH; Getis-Ord Gi*; HIV knowledge; Mozambique; Salud Rural; Sistemas de Información Geográfica; connaissance sur le VIH; geographic information systems; hot spot analysis; rural health; santé rurale; systèmes d'information géographique