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Epidemiology and spatial distribution of people diagnosed with HIV between 1997 and 2020 in Kerman, Iran
  1. Hossein Mirzaei1,2,
  2. Ali Mirzazadeh1,3,
  3. Mohsen Barouni4,
  4. Ebrahim Ranjbar5,
  5. Sana Eybpoosh6,
  6. Hamid Sharifi1,2
  1. 1HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
  2. 2Department of Biostatistics and Epidemiology, Faculty of Public Health, Kerman University of Medical Sciences, Kerman, Iran
  3. 3Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
  4. 4Health Services Management Research Center, Institute for Future Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
  5. 5Kerman Counseling Center for Behavioral Disorders, Kerman University of Medical Sciences, Kerman, Iran
  6. 6Department of Epidemiology and Biostatistics, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran
  1. Correspondence to Prof. Hamid Sharifi, HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman 7616911320, Iran; sharifihami{at}gmail.com

Abstract

Objective This study described the epidemiology and geographical distribution of people diagnosed with HIV in Kerman, Iran, between 1997 and 2020.

Methods We used case-based HIV surveillance data of all people diagnosed with HIV in Kerman between 1997 and 2020. We compared the age, gender, modes of transmission and spatial distribution of newly diagnosed HIV-infected people in three time periods (1997–2004, 2005–2012 and 2013–2020). The χ2 test for trend, one-sample t-test and Kruskal-Wallis H test were used to compare the differences between the three time periods. We also used ArcGIS to map both HIV services and people living with HIV (PLWH) in 2020. The nearest neighbour index and kernel density were used to identify the spatial distribution of PLWH.

Results A total of 459 (27.5% women) people were diagnosed with HIV during 1997–2020. The proportion of women (9.3% in 1997–2004 and 48.3% in 2013–2020, p<0.001), HIV infection through sexual contacts (11.6% in 1997–2004 and 50.3% in 2013–2020, p<0.001), HIV infection under the age of 5 years (0.8% in 1997–2004 and 5.4% in 2013–2020, p=0.01) and mean age at diagnosis among men (34.9 in 1997–2004 and 39.8 years in 2013–2020, p=0.004) significantly increased over time. 36.2% of diagnosed cases had CD4 counts under 200 x 10ˆ6/L between 2013 and 2020, with no significant improvement over time. Most newly diagnosed cases of HIV were from the eastern parts of the city. The clusters of PLWH in 2020 matched with the locations of HIV services.

Conclusion We observed important changes in HIV epidemiology regarding gender, modes of transmission, number of paediatric cases and density maps over time in Kerman. These changes should be considered for precise targeting of HIV prevention and treatment programmes.

  • epidemiology
  • HIV
  • delivery of health care

Data availability statement

Data are available upon reasonable request. Deidentified data are available upon reasonable request. Due to confidentiality or sensitivity issues, spatial data will not be shared.

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Data availability statement

Data are available upon reasonable request. Deidentified data are available upon reasonable request. Due to confidentiality or sensitivity issues, spatial data will not be shared.

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Footnotes

  • Handling editor Laith J Abu-Raddad

  • Contributors HM contributed to study design, literature review, data cleaning, data analysis and preparation of early drafts of the paper. AM contributed to study design, analysis interpretation and critical review of the early draft of the manuscript. MB contributed to the study design and preparation of early drafts of the paper. ER contributed to data extraction. SE contributed to study design and analysis interpretation. HS managed the implementation of the study and contributed to study design and preparation of early drafts of the paper. All authors contributed to the writing of the manuscript and approved the final version. HM acting as guarantor.

  • Funding This research was supported by the Kerman University of Medical Sciences (grant number: 99000587).

  • Disclaimer The content is solely the authors’ responsibility and does not necessarily represent the official views of the National Institutes of Health.

  • Competing interests ER is responsible for Kerman VCT.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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