Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Apr 23, 2020
Date Accepted: Feb 26, 2021
Geographical Disparities in HIV Seroprevalence among Men Who Have Sex with Men and People Who Inject Drugs in Nigeria: Exploratory Spatial Data Analysis
ABSTRACT
Background:
Assessment of geographical heterogeneity of HIV among men who have sex with men (MSM) and people who inject drugs (PWID) can usefully inform targeted HIV prevention and care strategies.
Objective:
We aimed to measure HIV seroprevalence and identify hotspots of HIV infection among MSM and PWID in Nigeria.
Methods:
We included all MSM and PWID accessing HIV testing services across seven prioritized states (Lagos, Nasarawa, Akwa Ibom, Cross Rivers, Rivers, Benue, and the Federal Capital Territory) in three geographic regions (North Central, South South, South West) between Oct 1, 2016 and Sept 30, 2017. We extracted data from national testing registers, georeferenced all HIV test results aggregated at the level of Local Government Areas (LGAs), and calculated HIV seroprevalence. We calculated and compared HIV seroprevalence from our study to the integrated biological and behavioral surveillance survey (IBBSS) 2014 and used global spatial autocorrelation and hotspot analysis to highlight patterns of HIV infection and to identify areas of significant clustering of HIV cases.
Results:
A positive HIV test was reported in 12.1% (95%CI 9.7-13.1) and 11.8% (95%CI 9.3-12.7) of the 26,423 MSMs and 9,474 PWIDs, respectively. Global spatial autocorrelation Moran´s I statistics revealed a clustered distribution of HIV infection among MSMs and PWIDs with a <5% and <1% likelihood that this clustered pattern could be due to chance respectively. Significant clusters of HIV infection (Getis-Ord-Gi* statistics) confined to the North Central, South-South regions were identified among MSM and PWID. Compared to the 2014 IBBSS our results suggest an increased HIV seroprevalence among PWID and a substantial decrease among MSM.
Conclusions:
This study identified geographical areas to prioritize for control of HIV infection among MSM and PWID, thus demonstrating that geographical information system technology is a useful tool to inform public health planning for interventions for epidemic control of HIV infection.
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