Rajneesh Joshi|Sanjay Mehendale
Determinants of consistently high HIV prevalence in Indian Districts: A multi-level analysis
Symbiosis International University|National AIDS Research Institute|Indian Council of Medical Research
introduction factors associated persistently high human immunodeficiency virus hiv prevalence levels several districts india well understood study undertaken determine association sociodemographic characteristics economic factors awareness hiv sexually transmitted infections stis condom use consistently high hiv prevalence indian districts ascertain whether associations differed across various regions india methods study carried including 640 districts india secondary analysis data obtained census india2011 hiv sentinel surveillance india district level household surveyiii done population profile socioeconomic characteristics levels hivsticondom awareness condom use compared districts without consistently high hiv prevalence due presence collinearity among predictor variables used principal component analysis principal component scores included covariates analysis considering districts level 1 regions level 2 multilevel analysis done generalised linear mixed models variance partition coefficient median odds ratio also calculated results sixtythree districts consistently high hiv prevalence found clustered south northeast regions india population size density urbanisation found positively associated consistently high hiv prevalence districts higher levels literacy better socioeconomic status higher proportion population reproductive age group late marriages positively associated consistently high hiv prevalence regions india except southern region higher levels knowledge role condoms hiv prevention condom use associated low hiv prevalence district level conclusions considerable heterogeneity among factors associated consistently high hiv prevalence district level different regions india necessitates special regionspecific strategies hiv control increasing awareness hiv alone sufficient controlling hiv epidemic need raise knowledge levels preventive measures hiv promote use condoms amongst population