D Sia1, É Nguemeleu Tchouaket2, M Hajizadeh3, H Karemere4, Y Onadja5, A Nandi6. 1. Départment des sciences infirmières, Université du Québec en Outaouais, Saint-Jérôme, Canada. Electronic address: Drissa.sia@uqo.ca. 2. Départment des sciences infirmières, Université du Québec en Outaouais, Saint-Jérôme, Canada. Electronic address: eric.tchouaket@uqo.ca. 3. School of Health Administration, Dalhousie University, Halifax, Nova Scotia, Canada. Electronic address: M.Hajizadeh@Dal.Ca. 4. Department of Public Health, Catholic University of Bukavu, Bukavu, Democratic Republic of the Congo. Electronic address: hkaremere@gmail.com. 5. Institut Supérieur des Sciences de la Population (ISSP), Université Ouaga 1 Joseph Ki-Zerbo, Ouagadougou, Burkina Faso. Electronic address: yonadja@issp.bf. 6. Institute for Health and Social Policy & Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montréal, Canada. Electronic address: arijit.nandi@mcgill.ca.
Abstract
OBJECTIVE: We aimed to quantify the extent to which country-level trends in HIV incidence in Sub-Saharan Africa (SSA) were influenced by gender inequalities, measured by gender gaps in educational attainment, income, and a Gender Inequality Index (GII). STUDY DESIGN: We examined the relation between gender inequality and HIV incidence using country-level panel data from 24 SSA countries for the period between 2000 and 2016. METHODS: Our goal was to estimate the relation between within-country changes in gender inequality and HIV incidence. We compared results from fixed effects and random effects models for estimating the effect of gender inequalities on changes in HIV incidence. Based on the results of the Hausman test, the fixed effects model was selected as the preferred approach. RESULTS: HIV incidence decreased by nearly one-half over the period from 2000 to 2016. We estimated that a one percent increase in the GII was associated with a 1.6 percent increase in HIV incidence (95% confidence interval = [0.21%; 3.00%]), after adjusting by country-level socio-economic and governance variables. CONCLUSIONS: Our study suggests that addressing gender inequalities is a potential strategy to reduce HIV incidence in the SSA region. To control HIV infection, policymakers and public health practitioners should support relevant interventions for promoting gender equality. Further work is needed to identify specific interventions to improve gender inequality and to examine their impacts on changes in HIV incidence.
OBJECTIVE: We aimed to quantify the extent to which country-level trends in HIV incidence in Sub-Saharan Africa (SSA) were influenced by gender inequalities, measured by gender gaps in educational attainment, income, and a Gender Inequality Index (GII). STUDY DESIGN: We examined the relation between gender inequality and HIV incidence using country-level panel data from 24 SSA countries for the period between 2000 and 2016. METHODS: Our goal was to estimate the relation between within-country changes in gender inequality and HIV incidence. We compared results from fixed effects and random effects models for estimating the effect of gender inequalities on changes in HIV incidence. Based on the results of the Hausman test, the fixed effects model was selected as the preferred approach. RESULTS: HIV incidence decreased by nearly one-half over the period from 2000 to 2016. We estimated that a one percent increase in the GII was associated with a 1.6 percent increase in HIV incidence (95% confidence interval = [0.21%; 3.00%]), after adjusting by country-level socio-economic and governance variables. CONCLUSIONS: Our study suggests that addressing gender inequalities is a potential strategy to reduce HIV incidence in the SSA region. To control HIV infection, policymakers and public health practitioners should support relevant interventions for promoting gender equality. Further work is needed to identify specific interventions to improve gender inequality and to examine their impacts on changes in HIV incidence.