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Geographic variation in sexual behavior can explain geospatial heterogeneity in the severity of the HIV epidemic in Malawi

Overview of attention for article published in BMC Medicine, February 2018
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  • In the top 25% of all research outputs scored by Altmetric
  • Good Attention Score compared to outputs of the same age (79th percentile)

Mentioned by

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1 policy source
twitter
9 tweeters
reddit
1 Redditor

Citations

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22 Dimensions

Readers on

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42 Mendeley
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Title
Geographic variation in sexual behavior can explain geospatial heterogeneity in the severity of the HIV epidemic in Malawi
Published in
BMC Medicine, February 2018
DOI 10.1186/s12916-018-1006-x
Pubmed ID
Authors

Laurence Palk, Sally Blower

Abstract

In sub-Saharan Africa, where ~ 25 million individuals are infected with HIV and transmission is predominantly heterosexual, there is substantial geographic variation in the severity of epidemics. This variation has yet to be explained. Here, we propose that it is due to geographic variation in the size of the high-risk group (HRG): the group with a high number of sex partners. We test our hypothesis by conducting a geospatial analysis of data from Malawi, where ~ 13% of women and ~ 8% of men are infected with HIV. We used georeferenced HIV testing and behavioral data from ~ 14,000 participants of a nationally representative population-level survey: the 2010 Malawi Demographic and Health Survey (MDHS). We constructed gender-stratified epidemic surface prevalence (ESP) maps by spatially smoothing and interpolating the HIV testing data. We used the behavioral data to construct gender-stratified risk maps that reveal geographic variation in the size of the HRG. We tested our hypothesis by fitting gender-stratified spatial error regression (SER) models to the MDHS data. The ESP maps show considerable geographic variation in prevalence: 1-29% (women), 1-20% (men). Risk maps reveal substantial geographic variation in the size of the HRG: 0-40% (women), 16-58% (men). Prevalence and the size of the HRG are highest in urban centers. However, the majority of HIV-infected individuals (~75% of women, ~ 80% of men) live in rural areas, as does most of the HRG (~ 80% of women, ~ 85% of men). We identify a significant (P < 0.001) geospatial relationship linking the size of the HRG with prevalence: the greater the size, the higher the prevalence. SER models show HIV prevalence in women is expected to exceed the national average in districts where > 20% of women are in the HRG. Most importantly, the SER models show that geographic variation in the size of the HRG can explain a substantial proportion (73% for women, 67% for men) of the geographic variation in epidemic severity. Taken together, our results provide substantial support for our hypothesis. They provide a potential mechanistic explanation for the geographic variation in the severity of the HIV epidemic in Malawi and, potentially, in other countries in sub-Saharan Africa.

Twitter Demographics

The data shown below were collected from the profiles of 9 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 42 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 42 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 11 26%
Student > Ph. D. Student 8 19%
Researcher 6 14%
Other 3 7%
Professor > Associate Professor 2 5%
Other 6 14%
Unknown 6 14%
Readers by discipline Count As %
Medicine and Dentistry 6 14%
Social Sciences 5 12%
Agricultural and Biological Sciences 4 10%
Nursing and Health Professions 4 10%
Biochemistry, Genetics and Molecular Biology 2 5%
Other 10 24%
Unknown 11 26%

Attention Score in Context

This research output has an Altmetric Attention Score of 8. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 16 February 2021.
All research outputs
#3,407,758
of 20,294,453 outputs
Outputs from BMC Medicine
#1,782
of 2,997 outputs
Outputs of similar age
#82,053
of 393,720 outputs
Outputs of similar age from BMC Medicine
#1
of 1 outputs
Altmetric has tracked 20,294,453 research outputs across all sources so far. Compared to these this one has done well and is in the 83rd percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 2,997 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 39.3. This one is in the 40th percentile – i.e., 40% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 393,720 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 79% of its contemporaries.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them