Indan Journal of Medical Research Indan Journal of Medical Research Indan Journal of Medical Research Indan Journal of Medical Research
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Year : 2012  |  Volume : 136  |  Issue : 7  |  Page : 23-29

Spatial modeling of HIV prevalence among the clients of female sex workers in Tamil Nadu, south India

1 National Institute of Epidemiology (ICMR), Chennai, India
2 Family Health International, New Delhi, India
3 National AIDS Research Institute (ICMR), Pune, India

Correspondence Address:
Vasna Joshua
Technical Officer, National Institute of Epidemiology, R-127, 3rd Avenue, Ayapakkam, Ambattur, Chennai 600 077
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Source of Support: None, Conflict of Interest: None

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Background & objectives: The spread of HIV infection is diverse and unpredictable and is often associated with the geographic factors. The objectives of this study were to identify significant predictors of HIV prevalence using spatial modeling and to produce a smoothened map of predicted values of HIV prevalence using the geographic information system (GIS) technology. Methods: A large cross-sectional survey Integrated Behavioural and Biological Assessment (IBBA) for 1203 clients of female sex workers (FSWs) from three districts (Chennai, Madurai and Salem) of Tamil Nadu, India during October and December 2006, were studied. The survey focused on a number of social, demographic, behavioural and biological indicators and spatial parameters that could be associated with the risk of HIV infection. These were used in a multivariate logistic regression model to predict the probability for positive cases of HIV among the clients of FSWs. To interpolate the prevalence levels across Tamil Nadu and to predict values for areas not covered in the sampling, the study area was divided into 26 clusters or polygons. The predicted HIV probability (prevalence) was aggregated to cluster/polygon level. For interpolation, the inverse distance weighting method (IDW) was used in the GIS methodology. Results: Literate clients, first sex at the younger age of 20 yr or less, clients not undergone HIV testing and who were sampled at the proximity of major roads and busy stations were at greater risk of being infected with HIV in Tamil Nadu. The smoothened surface obtained using GIS methodology showed the wide regional variation of predicted value of HIV prevalence in Tamil Nadu. Interpretation & conclusions: This study shows significance of the emerging GIS technology in the field of HIV/AIDS. The significant predictors of HIV infection and the regional variation of predicted values of HIV prevalence could accomplish better understanding and planning for the health officials in future.

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