Geographic Distribution of Human Immunodeficiency Virus in South Africa

Immo Kleinschmidt London School of Hygiene and Tropical Medicine, London, United Kingdom; Medical Research Council of South Africa, Durban, South Africa; Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina; Reproductive Health and HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa

Search for other papers by Immo Kleinschmidt in
Current site
Google Scholar
PubMed
Close
,
Audrey Pettifor London School of Hygiene and Tropical Medicine, London, United Kingdom; Medical Research Council of South Africa, Durban, South Africa; Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina; Reproductive Health and HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa

Search for other papers by Audrey Pettifor in
Current site
Google Scholar
PubMed
Close
,
Natashia Morris London School of Hygiene and Tropical Medicine, London, United Kingdom; Medical Research Council of South Africa, Durban, South Africa; Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina; Reproductive Health and HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa

Search for other papers by Natashia Morris in
Current site
Google Scholar
PubMed
Close
,
Catherine MacPhail London School of Hygiene and Tropical Medicine, London, United Kingdom; Medical Research Council of South Africa, Durban, South Africa; Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina; Reproductive Health and HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa

Search for other papers by Catherine MacPhail in
Current site
Google Scholar
PubMed
Close
, and
Helen Rees London School of Hygiene and Tropical Medicine, London, United Kingdom; Medical Research Council of South Africa, Durban, South Africa; Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina; Reproductive Health and HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa

Search for other papers by Helen Rees in
Current site
Google Scholar
PubMed
Close
Restricted access

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.

Author Notes

  • 1

    National Department of Health (South Africa), 2004. National HIV and Syphilis Antenatal Sero-Prevalence Survey in South Africa 2004. Pretoria. Available from www.health.gov.za.

    • PubMed
    • Export Citation
  • 2

    Shisana O, Rehle T, Simbayi LC, Parker W, Zuma K, Bhana A, Connolly C, Jooste S, Pillay V, 2005. South African National HIV Prevalence, HIV Incidence, Behaviour and Communication Survey. Cape Town, South Africa: Human Sciences Research Council Press.

    • PubMed
    • Export Citation
  • 3

    Joint United Nations Programme on HIV/AIDS, 2004 Report on the Global AIDS Epidemic. Geneva: UNAIDS.

    • PubMed
    • Export Citation
  • 4

    Erb-Leoncavallo A, Holmes G, Jacobs G, Urdang S, Vanek J, Zarb M, 2004. Women and HIV/AIDS: Confronting the Crisis. Geneva: The Joint United Nations Programme on HIV/AIDS. New York: The United Nations Population Fund, The United Nations Development Fund for Women; 2004.

    • PubMed
    • Export Citation
  • 5

    Pettifor AE, Rees HV, Kleinschmidt I, Steffenson A, MacPhail C, Hlongwa-Madikizela L, Vermaak K, Padian NS, 2005. Young people’s sexual health in South Africa: HIV prevalence and sexual behaviours from a nationally representative household survey. AIDS 19 :1525– 1534.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6

    Goldstein S, Usdin S, Scheepers E, Japhet G, 2005. Communicating HIV and AIDS, what works? A report on the impact evaluation of Soul City’s fourth series. J Health Commun 10 :465– 483.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7

    Pettifor A, Kleinschmidt I, Levin J, Rees H, MacPhail C, Hlongwa-Madikizela L, Vermaak K, Napier G, Stevens W, Padian N, 2005. A community-based study to examine the effect of a youth prevention intervention on young people aged 15– 24 in South Africa: results of the baseline survey. Trop Med Int Health 10 :971– 980.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8

    Statistics South Africa, 2001. Community Profile Databases: Census 2001. Product Reference No. 03-02-22. Available from http://www.statssa.gov.za

    • PubMed
    • Export Citation
  • 9

    Gallo D, George J, Fitchen J, Goldstein A, Hindahl M, 1997. Evaluation of a system using oral mucosal transudate for HIV-1 antibody screening and confirmatory testing. OraSure HIV Clinical Trials Group. JAMA 277 :254– 258.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10

    Pettifor AE, Rees HV, Steffenson A, Hlongwa-Madikizela L, MacPhail C, Vermaak K, Kleinschmidt I, 2004. HIV and Sexual Behaviour Among Young South Africans: A National Survey of 15–24 Year Olds. Johannesburg: RHRU and LoveLife.

    • PubMed
    • Export Citation
  • 11

    Longley P, Goodchild MF, Maguire DJ, Rhind DW, 2001. Geographic Information Systems and Science. Chichester, United Kingdom: John Wiley.

    • PubMed
    • Export Citation
  • 12

    Statistics South Africa, 2001. Census 2001 Products: Small Area Statistics. Reference number: 03-02-45. Available from http://www.statssa.gov.za/census01/html/C2001smallareastats.asp

    • PubMed
    • Export Citation
  • 13

    Christensen OF, Ribeiro PJ Jr, 2002. GeoRglm: a package for generalised linear spatial models. R News 2 :26– 28.

  • 14

    Elliott P, Wartenberg D, 2004. Spatial epidemiology: current approaches and future challenges. Environ Health Perspect 112 :998– 1006.

  • 15

    Swerdlow A, dos Santos Silva I, 1993. Atlas of Cancer Incidence in England and Wales 1968–85. Oxford, United Kingdom: Oxford University Press; 1993.

    • PubMed
    • Export Citation
  • 16

    Devesa SS, Grauman DG, Blot WJ, Pennello G, Hoover RN, Fraumeni JF Jr, 1999. Atlas of Cancer Mortality in the United States, 1950–1994. Washington, DC: U.S. Government Printing Office.

    • PubMed
    • Export Citation
  • 17

    Pickle LW, Mungiole M, Jones GK, White AA, 1996. Atlas of United States Mortality. Hyattsville, MD: National Center for Health Statistics.

    • PubMed
    • Export Citation
  • 18

    Kleinschmidt I, Sharp B, Mueller I, Vounatsou P, 2002. Rise in malaria incidence rates in South Africa: a small area spatial analysis of variation in time trends. Am J Epidemiol 155 :257–264.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19

    Kleinschmidt I, Omumbo J, Briët O, Van de Giesen N, Sogoba N, Mensah NK, Windmeijer P, Moussa M, Teuscher T, 2001. An empirical malaria distribution map for west Africa. Trop Med Int Health 6 :779– 786.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20

    Gemperli A, Vounatsou P, Kleinschmidt I, Bagayoko M, Lengeler C, Smith T, 2004. Spatial patterns of infant mortality in Mali: the effect of malaria endemicity. Am J Epidemiol 159 :64– 72.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21

    Kleinschmidt I, Ramkissoon A, Morris N, Mabude Z, Curtis B, Beksinska M, 2006. Mapping indicators of sexually transmitted infection services in the South African public health sector. Trop Med Int Health 11 :1047– 1057.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22

    Law DCG, Serre ML, Christakos G, Leone PA, Miller WC, 2004. Spatial analysis and mapping of sexually transmitted diseases to optimise intervention and prevention strategies. Sex Transm Infect 80 :294– 299.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23

    Kok P, Collinson M, 2006. Migration and Urbanization in South Africa. Report 03-04-02, Pretoria: Statistics South Africa.

    • PubMed
    • Export Citation
  • 24

    Lurie M, Williams B, Zuma K, Mkaya-Mwamburi D, Garnett G, Sturm AW, Sweat M, Gittelsohn J, Abdool Karim S, 2003. The impact of migration on HIV-1 transmission: a study of migrant and non-migrant men, and their partners. Sex Transm Dis 30 :149– 156.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25

    Collinson M, Kok P, Garenne M, 2006. Migration and Changing Settlement Patterns: Multilevel Data for Policy. Report 03-04-01, Pretoria: Statistics South Africa.

    • PubMed
    • Export Citation
  • 26

    Lurie MN, Williams BG, Zuma K, Mkaya-Mwamburi D, Garnett GP, Sweat MD, Gittelsohn J, Karim SS, 2003. Who infects whom? HIV-1 concordance and discordance among migrant and non-migrant couples in South Africa. AIDS 17 :2245– 2252.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 27

    Diggle PJ, Tawn JA, Moyeed R, 1998. Model-based geostatistics. J R Stat Soc C 47 :299– 350.

  • 28

    Diggle PJ, Ribeiro PJ, Christensen OF, 2003. An introduction to model-based geostatistics. Moller J, ed. Spatial Statistics and Computational Methods. New York: Springer Verlag, 43– 86.

    • PubMed
    • Export Citation
  • 29

    Gemperli A, Vounatsou P, 2003. Fitting generalised linear mixed models for point-referenced spatial data. J Modern Appl Stat Methods 2 :497– 511.

  • 30

    Environmental Sciences Research Institute, 2004. ArcMap™ Version 9.0. Redlands, CA: Environmental Sciences Research Institute.

    • PubMed
    • Export Citation
Past two years Past Year Past 30 Days
Abstract Views 235 182 7
Full Text Views 289 3 0
PDF Downloads 102 3 0
 

 

 

 
 
Affiliate Membership Banner
 
 
Research for Health Information Banner
 
 
CLOCKSS
 
 
 
Society Publishers Coalition Banner
Save