Journal article
Changing spatial patterns and increasing rurality of HIV prevalence in the Democratic Republic of the Congo between 2007 and 2013
Health and Place, Vol.39, pp.79-85
05/2016
DOI: 10.1016/j.healthplace.2016.02.009
PMCID: PMC4874876
PMID: 26974234
Abstract
The Democratic Republic of the Congo (DRC) has one of the lowest HIV prevalence in sub-Saharan Africa, estimated at 1.1% [0.9–1.3] of adults aged 15–49 in 2013 (UNAIDS). Within the 2 million km2 country, however, there exists spatial variation in HIV prevalence, with the highest HIV prevalence observed in the large cities of Kinshasa and Lubumbashi. Globally, HIV is an increasingly rural disease, diffusing outwards from urban centers of high HIV prevalence to places where HIV was previously absent or present at very low levels. Utilizing data collected during Demographic and Health Surveillance (DHS) in 2007 and 2013 in the DRC, we sought to update the map of HIV prevalence in the DRC as well as to explore whether HIV in the DRC is an increasingly rural disease or remains confined to urban areas. Bayesian kriging and regression indicate that HIV prevalence in rural areas of the DRC is higher in 2013 than in 2007 and that increased distance to an urban area is no longer protective against HIV as it was in 2007. These findings suggest that HIV education, testing and prevention efforts need to diffuse from urban to rural areas just as HIV is doing. •While overall prevalence of HIV remains low in the DRC, the spatial patterns of HIV have changed between 2007 and 2013.•In 2007, rural residence far from urban areas was protective against HIV.•In 2013, rural residence is no longer protective against HIV.•Women in the DRC, regardless of residential location, have higher HIV risk than men.•HIV is diffusing from urban to rural areas in the DRC.
Details
- Title: Subtitle
- Changing spatial patterns and increasing rurality of HIV prevalence in the Democratic Republic of the Congo between 2007 and 2013
- Creators
- Margaret Carrel - Department of Geographical & Sustainability Sciences, 303 Jessup Hall, University of Iowa, Iowa City, IA 52245, USAMark Janko - Department of Geography, CB3220, Carolina Hall, University of North Carolina-Chapel Hill, Chapel Hill, NC, USAMelchior Kashamuka Mwandagalirwa - Department of Epidemiology, CB7435, McGavran-Greenberg Hall, University of North Carolina-Chapel Hill, Chapel Hill, NC, USACamille Morgan - University of North Carolina at Chapel HillFranck Fwamba - National AIDS Control Program (PNLS), Kinshasa, Democratic Republic of the CongoJérémie Muwonga - National AIDS Control Program (PNLS), Kinshasa, Democratic Republic of the CongoAntoinette K Tshefu - Ecole de Sante Publique, Faculte de Medecine, University of Kinshasa, Kinshasa, Democratic Republic of the CongoSteven Meshnick - Department of Epidemiology, CB7435, McGavran-Greenberg Hall, University of North Carolina-Chapel Hill, Chapel Hill, NC, USAMichael Emch - Department of Geography, CB3220, Carolina Hall, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA
- Resource Type
- Journal article
- Publication Details
- Health and Place, Vol.39, pp.79-85
- DOI
- 10.1016/j.healthplace.2016.02.009
- PMID
- 26974234
- PMCID
- PMC4874876
- NLM abbreviation
- Health Place
- ISSN
- 1353-8292
- eISSN
- 1873-2054
- Publisher
- Elsevier Ltd
- Grant note
- DOI: 10.13039/100000002, name: NIH, award: R01AI107949-01A1, R24 HD050924; DOI: 10.13039/100000001, name: NSF BCS, award: 1339949
- Language
- English
- Date published
- 05/2016
- Academic Unit
- Epidemiology; Interdisciplinary Programs; Geographical and Sustainability Sciences; Internal Medicine
- Record Identifier
- 9983983673202771
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