Shujuan Yang / West China School of Public Health and West China Fourth Hospital, Sichuan University
Background: Liangshan Yi Autonomous Prefecture in Southwest China has a high HIV prevalence rate. By 2017, there were 35,513 confirmed HIV/AIDS cases. This study examines the changing mode of transmission among newly infected women and explores the spatial heterogeneity in the factors associated with heterosexual transmission in this minority region.
Methods: The 2011-2014 new female HIV infection data was collected through four different sources. New infections were identified by BED-CEIA. A fully Bayesian analysis of conjugate hierarchical model was used to examine the proportion of heterosexual transmission of new female HIV infections for all townships in the Liangshan Yi Prefecture. Geographically weighted logistic regression (GWLR) was utilized to explore geographical variations.
Results: An analytical sample of 927 new female HIV infectors was collected to explore the mode of transmission. The rates of heterosexual transmission of new female HIV infections in 2011 were below 20%, whereas the rates for all townships in 2014 were nearly 85%. About 30% of townships showed a significant difference in the mode of HIV transmission of new female infections between Yi women and women of other ethnic origin. With a primary school education or being single or married decreased the odds of HIV infection through heterosexual contact for women.
Conclusions: Heterosexual transmission is the predominant mode of HIV transmission in the Liangshan Yi Prefecture among women and this transformation is characterized by a clear spatial diffusion pattern and trend. Sociodemographic factors that are associated with the mode of HIV transmission also demonstrate geographical variations.