TITLE:
Correlation between National Peak HIV Prevalence and Concurrency, STI Treatment Capability, Condom Use and Circumcision: An Ecological Study
AUTHORS:
Chris R. Kenyon, Jozefien Buyze
KEYWORDS:
HIV, Sexual Network, Epidemiology, Peak HIV Prevalence, Ecological
JOURNAL NAME:
World Journal of AIDS,
Vol.4 No.2,
June
25,
2014
ABSTRACT:
Background: The extent
of the differential spread of HIV around the world remains incompletely
explained. This paper examines the extent to which five explanatory variables
(circumcision prevalence, condom usage, STI treatment coverage, number of sex
partners, partner concurrency) are correlated with peak HIV prevalence rates at
a country level. Methods: We performed linear regression analysis to measure
the association between each of the independent variables and the national peak
HIV prevalence rates for 15 - 49 years old. Results: Our analysis shows a
strong positive association between peak HIV prevalence and the prevalence of
partner concurrency (rho = 0.853; P = 0.001). There was no association between
peak HIV prevalence and circumcision prevalence (rho = 0.118; P = 0.161),
condom usage (rho = 0.048; P = 0.794), STI treatment coverage (rho = 0.143; P =
0.136) and number of sex partners (rho = 0.134; P = 0.298) at a global level.
There was however a strong negative association between peak HIV prevalence and
circumcision prevalence when the analysis was limited to countries within sub
Saharan Africa (rho = -0.659; P = 0.000). Sub Saharan Africa had the second and
third highest circumcision rates in the world when the circumcision prevalence
thresholds were set at 80% and 20% respectively. Conclusions: Differences in
the prevalence of circumcision likely influence differential peak HIV prevalence
within sub Saharan Africa but are implausible causes for the higher HIV prevalence
in this region. The close association found between concurrency and HIV
prevalence requires replication in further studies.