{
  "abstract": "Objectives In Guinea, around 17 new cases of HIV occurred each day and it was responsible for 10 deaths a day in 2022. In addition to this burden, regional disparities have emerged over the years. This study aimed to describe and explain the uneven distribution of HIV infection in Guinea using spatial analysis.Design This is a retrospective cross-sectional secondary analysis using data from the 2012 and 2018 Guinea Demographic and Health Survey (DHS).Setting This study was conducted in Guinea.Participants and methods We conducted a secondary analysis of data from 300 and 400 enumeration areas, respectively, included in the 2012 and 2018 DHS Program for participants aged 15 to 49 who underwent HIV testing. Spatial analysis methods, including Moran I, interpolation and Kulldorff’s scan statistic, were applied to examine variation and identify high-risk spatial clusters of HIV prevalence rate. The potential relationship between HIV status and socio-demographic, biological, behavioural and socio-environmental explanatory variables was explored using logistic regression at individual level.Results In total, 7922 individuals in 2012 and 8539 in 2018 participated in the study. HIV prevalence rate in 2012 and 2018 was 1.9% and 1.5%, respectively. Across Guinea’s 33 prefectures, HIV prevalence rate varied from 0% to 3.9% in 2012 and from 0% to 3.5% in 2018. Spatial analysis identified four significant high-risk spatial clusters in 2012 and one high-risk cluster in 2018. The high-risk clusters in 2012 were in Kissidougou (relative risk (RR)=3.97; p value=0.037), Matam (RR=2.80; p value=0.019), Pita (RR=3.46; p value=0.035) and N’zerekore prefectures (RR=6.08; p value=0.027), the high-risk cluster in 2018 was located in Boffa prefecture (RR=3.95; p value=0.022). Factors significantly and positively associated with HIV infection in 2012 included age class 25–34 (aOR: 2.20; 95% CI 1.40 to 3.47), age class 35–49 (aOR: 2.43; 95% CI 1.51 to 3.92), number of HIV healthcare facilities>30 (aOR: 2.14; 95% CI 1.34 to 3.43). HIV infection was significantly lower in men (aOR: 0.52; 95% CI 0.35 to 0.77). In 2018, in addition to age groups 25–34 years (aOR=1.90; 95% CI 1.18 to 3.04) and 35–49 years (aOR=2.25; 95% CI 1.40 to 3.64), the Soussou ethnicity group (aOR=1.73; 95% CI 1.04 to 2.87) was also positively associated with HIV infection.Conclusion This study describes the spatial distribution of HIV prevalence rate and identified high-risk clusters in Guinea. In addition, risk factors associated with HIV status were identified. The information can help prioritise surveillance and response efforts to control HIV in Guinea.",
  "authors": [
    {
      "affiliations": [
        "Centre de Recherche et de Formation en Infectiologie de Guinee, Conakry, Guinea",
        "Direction Nationale de l’Epidémiologie et de la lutte contre la maladie (DNELM), Ministère de la Santé et de l’hygiène publique, Conakry, Guinea"
      ],
      "name": "Ibrahima Balde"
    },
    {
      "affiliations": [
        "Public Health, National Institute of Public Health, Conakry, Guinea",
        "Public Health Department, Faculty of Health Sciences and Technology, Conakry, Guinea"
      ],
      "name": "Almamy Amara Toure"
    },
    {
      "affiliations": [
        "Geomatys, Montpellier, France",
        "Association Actions en Santé, Montpellier, France"
      ],
      "name": "Jessica Lee Abbate"
    },
    {
      "affiliations": [
        "Faculty of Health Sciences and Technology, Gamal Abdel Nasser University, Conakry, Guinea"
      ],
      "name": "Abdoulaye Sow"
    },
    {
      "affiliations": [
        "Service National des Maladies Infectieuses et Tropicales (SMIT), Donka National Hospital, Conakry, Guinea"
      ],
      "name": "Mamadou Saliou Sow"
    },
    {
      "affiliations": [
        "Faculty of Health Sciences and Technology, Gamal Abdel Nasser University, Conakry, Guinea",
        "Épidémiologie et recherche clinique, Centre de Recherche et de Formation en Infectiologie de Guinee, Conakry, Guinea"
      ],
      "name": "Salifou Talassone Bangoura"
    },
    {
      "affiliations": [
        "Épidémiologie et recherche clinique, Centre de Recherche et de Formation en Infectiologie de Guinee, Conakry, Guinea"
      ],
      "name": "Castro Gbêmêmali Hounmènou"
    },
    {
      "affiliations": [
        "Public health Department, Faculty of Health Sciences and Technology, Gamal Abdel Nasser University, Conakry, Guinea"
      ],
      "name": "Sidikiba Sidibé"
    },
    {
      "affiliations": [
        "National Malaria Control Program, Conakry, Guinea"
      ],
      "name": "Alioune Camara"
    },
    {
      "affiliations": [
        "African Center of Excellence for Communicable Disease Prevention and Control (CEA-PCMT), Conakry, Guinea"
      ],
      "name": "Alexandre Delamou"
    },
    {
      "affiliations": [
        "Institut Supérieur des Sciences de la Santé, Université Nazi BONI, Bobo-Dioulasso, Burkina Faso",
        "Centre Hospitalier Universitaire Souro Sanou, Bobo-Dioulasso, Burkina Faso"
      ],
      "name": "Cheick Ahmed Ouattara"
    },
    {
      "affiliations": [
        "SESSTIM UMR 1252, Marseille, France"
      ],
      "name": "Sokhna Dieng"
    },
    {
      "affiliations": [
        "Centre de Recherche et de Formation en Infectiologie de Guinee, Conakry, Guinea"
      ],
      "name": "Abdoulaye Touré"
    }
  ],
  "title": "Spatial distribution of HIV prevalence and associated factors in Guinea: retrospective cross-sectional study using Demographic and Health Surveys (DHS) data from 2012 and 2018",
  "uid": "18c44c0c-3ec7-5c13-b5a3-267407b60af1"
}