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Member Research & Reports

Member Research & Reports

Columbia: Striking Variations in HIV Prevalence Within Sub-Saharan Africa

A new study co-authored by Dr. Jessica Justman, senior technical director at ICAP at Columbia University and associate professor of Medicine in Epidemiology at Columbia University Mailman School of Public Health, captures the evolution and variation of the human immunodeficiency virus (HIV) epidemic over space and time in sub-Saharan Africa by using detailed provincial- and district-level maps of HIV prevalence in each country, down to the level of a small city.

The study, published in Nature, is the first to map a comprehensive and comparable set of subnational HIV prevalence estimates among adults in 47 sub-Saharan African countries over nearly two decades. It includes data from ten countries in the Population-based HIV Impact Assessment (PHIA) Project, funded by the U.S. President’s Emergency Fund for AIDS Relief (PEPFAR) and implemented by ICAP in partnership with the U.S. Centers for Disease Control and Prevention (CDC).

“This research provides an unprecedented level of detail, down to 5×5 km cells, about the local scope of the HIV epidemic in sub-Saharan Africa between 2000-2017,” noted Dr. Justman, “As we have seen with PHIA survey results, the findings in this paper demonstrate just how varied the epidemic is within and across countries.”

HIV remains a leading cause of illness and death in sub-Saharan Africa. Despite rapid scale-up of antiretroviral therapy, 34 percent of people in east and southern Africa and 60 percent in west and central Africa living with HIV are currently not receiving any treatment.

The new maps of HIV prevalence will help target HIV programs to their location-specific needs. For example, most countries have more than a twofold difference in prevalence between provinces or districts, and one quarter of countries have a more than fivefold difference.

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