Please use this identifier to cite or link to this item: http://hdl.handle.net/10397/82155
Title: The changing modes of human immunodeficiency virus transmission and spatial variations among women in a minority prefecture in southwest China : an exploratory study
Authors: Xiao, C
Jike, C
Liu, D
Jia, P 
Xu, X
Xiao, L
Yu, G
Nan, L
Sun, X
Ge, J
Wang, J
Wang, K
Liao, Q
Wang, Q
Wenwen, Z
Yang, S
Issue Date: 2020
Source: Medicine, 2020, v. 99, no. 6, e18776
Abstract: Liangshan Yi Autonomous Prefecture in Southwest China has a high human immunodeficiency virus (HIV) prevalence rate. This study examined the changing modes of HIV transmission among women with new HIV infections and explored the spatial heterogeneities in the factors associated with heterosexual transmission in this minority region.The data consisting of women with new HIV infections from 2011 to 2014 were collected from multiple sources. New infections were identified by BED capture enzyme immunoassay. The Bayesian hierarchical model was used to estimate the proportion of women with new HIV infections via heterosexual transmission across all townships in the Prefecture. A geographically weighted regression (GWR) model was utilized to investigate spatial variations in the sociodemographic characteristics associated with the changing modes of HIV transmission.An analytical sample of 927 women with new HIV infections was constructed and utilized to investigate the changing mode of HIV transmission. The rate of heterosexual transmission among women with new HIV infections in 2011 was below 20%. However, by 2014 this rate dramatically increased to nearly 80%. Among sociodemographic characteristics, GWR results revealed significant ethnic differences in heterosexual HIV transmission between Yi women and women in other ethnic groups, with Yi women demonstrating a lower risk of infection through heterosexual transmission. However, such ethnic differences were observed only in 30% of the townships in the Prefecture. Moreover, having a primary education decreased the odds of heterosexual transmission, which was observed in about 56% of the townships. Also, being involved in occupations other than agriculture or animal husbandry and being single or married decreased the odds of HIV infection through heterosexual contact among women, which did not significantly vary across the Prefecture.Heterosexual transmission was the predominant mode of HIV transmission among women in the Prefecture, and this transformation was clearly marked by a fast-growing trend and a spatial diffusion pattern. Spatial variations also existed in sociodemographic factors that were associated with the changing modes of HIV transmission.
Publisher: Lippincott Williams & Wilkins
Journal: Medicine 
EISSN: 1536-5964
DOI: 10.1097/MD.0000000000018776
Rights: Copyright © 2020 the Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal.
The following publication Xiao C, Jike C, Liu D, Jia P, Xu X, Xiao L, Yu G, Nan L, Sun X, Ge J, Wang J, Wang K, Liao Q, Wang Q, Wenwen Z, Yang S. The changing modes of human immunodeficiency virus transmission and spatial variations among women in a minority prefecture in southwest China: an exploratory study. Medicine 2020;99:6(e18776), is available at https://doi.org/ 10.1097/MD.0000000000018776
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