Browsing by Author "Rekola, Hanna"

HIV and AIDS epidemic remains an issue burdening most severely developing countries of the Global South and especially Sub-Saharan Africa. Globally 37 million people are living with AIDS and from these more than half in SSA. In Namibia, estimated HIV prevalence is 13.8% compared to the average 7.1% in East and Southern Africa and global average 0.8%. Until recently, representative data of HIV prevalence has not been available in developing countries. Currently HIV testing is included in Demographic and Health Surveys which are conducted in more than 90 developing countries around the world with the support of the DHS Program funded by USAID. These data also often include georeference, which enables also spatial analysis of the HIV epidemic. In this study, HIV epidemic in Namibia has been studied using traditional methods utilised in population studies, which have been complemented with methods of spatial approach. Sub-regional estimates for HIV prevalence inside administrative regions have been modelled using Kernel density estimation. Factors driving the epidemic have been assessed with a logistic regression model that estimates individual’s HIV risk. In Namibia, HIV prevalence is highest in North-Central Namibia and Caprivi strip. However, according to sub-regional estimates for HIV prevalence there exist variation also inside these areas. In North-Central Namibia, high rates of HIV prevalence depended more on proximity to urban centre than population density alone. Presence of urban centres did not increase HIV prevalence everywhere in Namibia. Also inside urban areas, for example Windhoek, sub-regional estimates for HIV prevalence differed considerably. In the logistic regression model, the following results were found: Women have 1.8 times higher odds for being HIV positive. 30-39-year olds had highest odds for being HIV positive. For men only, odds ratio was highest among 40-49-year olds. Higher educational attainment and higher wealth quintile decreased individual’s HIV risk. Formerly married had higher risk for HIV. Certain language groups had higher odds for being HIV positive, these included especially Lozi and Oshiwambo. Increasing number of lifetime number of sexual partners increased individual’s HIV risk. From regional factors, strong migration inflow and average HIV prevalence in the area increased individual’s HIV risk. The DHS data is available free of charge for academic purposes. Other data and all software used in this study are open source. These data and software were utilised partly in order to demonstrate that spatial approach on the HIV epidemic is possible even without vast resources. Especially in developing countries utilisation of open source opens up possibilities that would otherwise be limited. The results of this study confirm to a large extent findings from other developing countries of the Global South where DHS data have been used in HIV studies. However, characteristics unique for the epidemic in Namibia were also found. The dynamics of the HIV epidemic are difficult to grasp and it is important that even though the situation is improving these complexities are challenged and the phenomenon further investigated.