The aim of this study was to determine the association
between violent conflict and HIV incidence within and across 36 sub-Saharan Africa
countries between 1990 and 2012.
We used generalized linear mixed effect modeling to estimate
the effect of conflict periods on country-level HIV incidence. We specified
random intercepts and slopes to account for across and within country variation
over time. We also conducted a sub-analysis of countries who experienced
conflict to assess the effect of conflict intensity on country-level HIV
incidence. All models controlled for level of economic development, number of
refugees present in the country, and year.
We found that, compared to times of peace, the HIV incidence
rate increased by 2.1 per 1000 infections per year (95%CI: 0.39, 3.87) in the 5
years prior to conflict. Additionally, we found a decrease of 0.7 new
infections per 1000 people per year (95%CI: -1.44, -0.01) in conflicts with 25
to 1000 battle-related deaths and a decrease of 1.5 new infections per 1000
people per year (95%CI:-2.50, -0.52) for conflict with more than 1000
battle-related deaths, compared to conflicts with less than 25 battle-related
deaths
Our results demonstrate that HIV infection rates increase in
the years immediately prior to times of conflict; however, we did not identify
a significant increase during and immediately following periods of violent
conflict. Further investigation, including more rigorous data collection, is
needed, as is increased aid to nations at risk of violent conflict to help in
the fight against HIV/AIDS in sub-Saharan Africa.
Below: Annual Minimum, Maximum, and Mean HIV Incidence in 36 Countries in sub-Saharan Africa, 1990–2012
Full article at: http://goo.gl/JbyPdU
By:
Department of Epidemiology,
Brown University School of Public Health, Providence, RI, United States of
America
More at: https://twitter.com/hiv_insight
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