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Geographic Distribution of Human Immunodeficiency Virus in South Africa

In common with most countries, little is know about the geographic distribution of human immunodeficiency virus (HIV) in South Africa. Variations in HIV infection of persons 15–24 years of age were modeled and mapped using generalized linear spatial models and Bayesian prediction based on data from a national HIV household survey conducted in 2003 and comprising 11,904 youth from approximately 700 enumeration areas that were randomly selected from the national census. The maps show considerable variation in HIV prevalence within provinces. The lowest levels were found in inland rural areas of the Western Cape, and the highest in northwestern parts of KwaZulu Natal, southern Mpumalanga, and eastern Free State. Prevalence of HIV was associated with ethnicity, urban status, and unemployment. Detailed maps of HIV prevalence can be effectively used in guiding and focusing intervention programs to areas of particular need.

Received September 4, 2006. Accepted for publication November 1, 2006.

^* Address correspondence to Immo Kleinschmidt, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK. E-mail: Immo.kleinschmidt{at}lshtm.ac.uk

Authors’ addresses: Immo Kleinschmidt, Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom, Telephone: 44 20 7927 2103, Fax: 44 20 7636 8739, E-mail: Immo.kleinschmidt{at}lshtm.ac.uk. Natasha Morris, Medical Research Council of South Africa, 491 Ridge Road, Durban, South Africa, Telephone: 27-31-203- 4806, Fax: 27-31-203-4704, E-mail: nmorris{at}mrc.ac.za. Audrey Pettifor, Department of Epidemiology, University of North Carolina, Chapel Hill, NC 27514, E-mail: a.pettifor{at}rhrujhb.co.za. Catherine MacPhail and Helen Rees, Reproductive Health and HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa, E-mails: c.macphail{at}rhrujhb.co.za and h.rees{at}rhrujhb.co.za.