{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T15:34:48Z","timestamp":1792424088564,"version":"4.5.0"},"reference-count":61,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T00:00:00Z","timestamp":1755043200000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001713","name":"European and Developing Countries Clinical Trials Partnership","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001713","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100015691","name":"Division of Microbiology and Infectious Diseases","doi-asserted-by":"publisher","award":["R01AI136664"],"award-info":[{"award-number":["R01AI136664"]}],"id":[{"id":"10.13039\/100015691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["INV\u2010006733"],"award-info":[{"award-number":["INV\u2010006733"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000156","name":"Fonds de Recherche du Qu\u00e9bec - Sant\u00e9","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000156","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["MR\/R015600\/1"],"award-info":[{"award-number":["MR\/R015600\/1"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Int AIDS Soc."],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Socio\u2010demographic and geographic disparities in HIV prevalence, uptake of HIV testing and access to antiretroviral therapy (ART) persist in high HIV burden countries. Understanding demographic, spatial and temporal factors can guide interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analysed 108 geo\u2010referenced population\u2010based surveys conducted over 2000\u20132023 across 33 African countries, involving 2.3 million respondents. Multilevel Bayesian logistic regression models assessed associations between HIV outcomes (HIV prevalence, recent HIV testing and ART coverage) and socio\u2010demographic characteristics (age, education, place of residence, relative wealth), geographic location (country, district) and time trends. Separate models were estimated for men and women in central, eastern, southern and western Africa.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Inequalities in HIV risk and access to testing and treatment services were driven by differences in educational attainment and within\u2010country variations. In southern Africa, women with tertiary education had a 12%\u2010point lower HIV prevalence (95% Credible Interval [CrI]: \u221227% to \u22122%) than those with less than primary education. In eastern Africa, they had a 13%\u2010points (95% CrI: 2\u221222%) higher probability of recent HIV testing. Associations with relative wealth were weaker and more heterogeneous: in southern Africa, HIV prevalence shifted over time from higher to lower wealth quintiles, and adolescent girls and young women became the most frequently tested age group. In central Africa, wealthier men maintained higher recent testing and ART coverage levels. District\u2010level variations accounted for disparities in HIV outcomes. In western Africa, the expected difference in ART coverage between individuals with similar socio\u2010demographic characteristics living in different districts was 14%\u2010points (95% CrI: 3\u221232%) for men and 10%\u2010points (95% CrI: 3\u221227%) for women.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Disparities in HIV outcomes are strongly associated with differences in education, and across districts of the same country. Higher education levels are associated with lower HIV prevalence, greater testing and higher ART coverage, while districts with limited services sustain higher population viraemia. Despite the scale\u2010up of HIV prevention and treatment programmes, important disparities remain, and renewed education\u2010centred and geographically targeted efforts are needed to close gaps.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jia2.70024","type":"journal-article","created":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T04:49:18Z","timestamp":1755146958000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Socio\u2010demographic and geographic disparities in HIV prevalence, HIV testing and treatment coverage: An analysis of 108 national household surveys in 33 African countries"],"prefix":"10.1002","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9663-7561","authenticated-orcid":false,"given":"Adrien","family":"Allorant","sequence":"first","affiliation":[{"name":"Department of Social Statistics and Demography University of Southampton  Southampton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salome","family":"Kuchukhidze","sequence":"additional","affiliation":[{"name":"Center for Communicable Disease Dynamics Department of Epidemiology Harvard T.H. Chan School of Public Health  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Stannah","sequence":"additional","affiliation":[{"name":"Center for Communicable Disease Dynamics Department of Epidemiology Harvard T.H. Chan School of Public Health  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiqing","family":"Xia","sequence":"additional","affiliation":[{"name":"Center for Communicable Disease Dynamics Department of Epidemiology Harvard T.H. Chan School of Public Health  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanele S.","family":"Masuku","sequence":"additional","affiliation":[{"name":"United Nations Program on HIV\/AIDS (UNAIDS)  Johannesburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gatien K.","family":"Ekanmian","sequence":"additional","affiliation":[{"name":"United Nations Program on HIV\/AIDS (UNAIDS)  Johannesburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7728-728X","authenticated-orcid":false,"given":"Jeffrey W.","family":"Imai\u2010Eaton","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Biostatistics, and Occupational Health McGill University  Montr\u00e9al Quebec Canada"},{"name":"MRC Centre for Global Infectious Disease Analysis School of Public Health, Imperial College  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8363-4388","authenticated-orcid":false,"given":"Mathieu","family":"Maheu\u2010Giroux","sequence":"additional","affiliation":[{"name":"Center for Communicable Disease Dynamics Department of Epidemiology Harvard T.H. Chan School of Public Health  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,8,13]]},"reference":[{"key":"e_1_2_14_2_1","unstructured":"UNAIDS Data 2023[Internet].Geneva:Joint United Nations Programme on HIV\/AIDS;2024. [cited 2024 Aug 20]. Available from:https:\/\/www.unaids.org\/en\/resources\/fact\u2010sheet"},{"key":"e_1_2_14_3_1","volume-title":"A framework for understanding and addressing HIV\u2010related inequalities [Internet]","year":"2022"},{"key":"e_1_2_14_4_1","unstructured":"Joint United Nations Programme on HIV\/AIDS (UNAIDS). UNAIDS. Fast\u2010Track: Ending the AIDS Epidemic by 2030. Vol. 36.Geneva;2014."},{"key":"e_1_2_14_5_1","volume-title":"Monitoring health for the SDGs. [Internet]","author":"World Health Statistics 2024","year":"2024"},{"key":"e_1_2_14_6_1","volume-title":"Global AIDS Strategy 2021\u20132026 \u2014 End Inequalities. End AIDS","year":"2021"},{"key":"e_1_2_14_7_1","volume-title":"Global indicator framework for the Sustainable Development Goals and targets of the 2030 Agenda for Sustainable Development","author":"United Nations","year":"2017"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(19)30378-9"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(16)30186-2"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/1476-072X-1-4"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/nm0597-553"},{"key":"e_1_2_14_12_1","volume-title":"Identifying populations at greatest risk of infection\u2014geographic hotspots and key populations [Internet]","author":"UNAIDS Reference Group on Estimates, Modeling and Projections","year":"2013"},{"key":"e_1_2_14_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-019-1200-9"},{"key":"e_1_2_14_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(21)00051-5"},{"key":"e_1_2_14_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.25788"},{"key":"e_1_2_14_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(21)00069-2"},{"key":"e_1_2_14_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(20)30108-X"},{"key":"e_1_2_14_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(16)30451-0"},{"key":"e_1_2_14_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(20)30208-4"},{"key":"e_1_2_14_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000003388"},{"key":"e_1_2_14_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(20)30315-5"},{"key":"e_1_2_14_22_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.5705"},{"key":"e_1_2_14_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(16)00037-0"},{"key":"e_1_2_14_24_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1002489"},{"key":"e_1_2_14_25_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6948a1"},{"key":"e_1_2_14_26_1","doi-asserted-by":"publisher","DOI":"10.1353\/dem.0.0006"},{"key":"e_1_2_14_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.aids.0000300532.51860.2a"},{"key":"e_1_2_14_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2022.101652"},{"key":"e_1_2_14_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.25470"},{"key":"e_1_2_14_30_1","volume-title":"Consolidated guidelines on HIV prevention, testing, treatment, service delivery and monitoring: recommendations for a public health approach [Internet]. 2021 update","author":"World Health Organization","year":"2021"},{"key":"e_1_2_14_31_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1801934"},{"key":"e_1_2_14_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(24)00003-1"},{"key":"e_1_2_14_33_1","unstructured":"DHS Program. AIDS indicator survey (AIS). [Internet]. Available from:https:\/\/dhsprogram.com\/Methodology\/Survey\u2010Types\/index.cfm. Accessed 20 Jun 2024."},{"key":"e_1_2_14_34_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph19138125"},{"key":"e_1_2_14_35_1","volume-title":"Survey sampling [Internet]","author":"Kish L","year":"1965"},{"key":"e_1_2_14_36_1","volume-title":"Standard Country and Area Codes Classifications [Internet]","author":"United Nations Statistics Division","year":"2022"},{"key":"e_1_2_14_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467-9531.2007.00181.x"},{"key":"e_1_2_14_38_1","doi-asserted-by":"publisher","DOI":"10.2307\/2669316"},{"key":"e_1_2_14_39_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pgph.0001731"},{"key":"e_1_2_14_40_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000003329"},{"key":"e_1_2_14_41_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-3156.2002.00889.x"},{"key":"e_1_2_14_42_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-019-1872-1"},{"key":"e_1_2_14_43_1","doi-asserted-by":"publisher","DOI":"10.1215\/00703370-9000609"},{"key":"e_1_2_14_44_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-016-3715-4"},{"key":"e_1_2_14_45_1","doi-asserted-by":"publisher","DOI":"10.2196\/10482"},{"key":"e_1_2_14_46_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.aids.0000300533.59483.95"},{"key":"e_1_2_14_47_1","doi-asserted-by":"publisher","DOI":"10.7448\/IAS.19.1.20605"},{"key":"e_1_2_14_48_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0208167"},{"key":"e_1_2_14_49_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000003158"},{"key":"e_1_2_14_50_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-021-10472-x"},{"key":"e_1_2_14_51_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0173928"},{"key":"e_1_2_14_52_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000002504"},{"key":"e_1_2_14_53_1","volume-title":"The impact of HIV stigma and discrimination on HIV testing, antiretroviral treatment, and viral suppression in Africa: a pooled analysis of population\u2010based surveys [Internet]","author":"Doyle CM","year":"2025"},{"key":"e_1_2_14_54_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-021-06316-4"},{"key":"e_1_2_14_55_1","doi-asserted-by":"publisher","DOI":"10.1093\/heapol\/czad096"},{"key":"e_1_2_14_56_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1003861"},{"key":"e_1_2_14_57_1","doi-asserted-by":"crossref","unstructured":"StevensO SabinK AndersonR GarciaSA WillisK RaoA et\u00a0al.Population size HIV prevalence and antiretroviral therapy coverage among key populations in sub\u2010Saharan Africa: collation and synthesis of survey data 2010\u20132023 [Internet].2022. [cited 2024 Jun 24]. Available from:http:\/\/medrxiv.org\/lookup\/doi\/10.1101\/2022.07.27.22278071","DOI":"10.1101\/2022.07.27.22278071"},{"key":"e_1_2_14_58_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000003321"},{"key":"e_1_2_14_59_1","article-title":"Trends in HIV testing, the treatment cascade, and HIV incidence among men who have sex with men in Africa: a systematic review and meta\u2010regression analysis [Internet]","author":"Stannah J","year":"2022","journal-title":"medRxiv"},{"key":"e_1_2_14_60_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11205-019-02187-9"},{"key":"e_1_2_14_61_1","unstructured":"RutsteinSO StaveteigS.Making the demographic and health surveys wealth index comparable. DHS Methodological Reports No. 9. Rockville Maryland. USA.2014."},{"key":"e_1_2_14_62_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-54170-1"}],"container-title":["Journal of the International AIDS Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jia2.70024","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jia2.70024","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jia2.70024","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T15:35:22Z","timestamp":1770910522000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jia2.70024"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8]]},"references-count":61,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2025,8]]}},"alternative-id":["10.1002\/jia2.70024"],"URL":"https:\/\/doi.org\/10.1002\/jia2.70024","archive":["Portico"],"relation":{},"ISSN":["1758-2652","1758-2652"],"issn-type":[{"value":"1758-2652","type":"print"},{"value":"1758-2652","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8]]},"assertion":[{"value":"2024-12-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-24","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-13","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70024"}}