{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T06:18:45Z","timestamp":1783491525396,"version":"3.55.0"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Epidemiol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Malawi has made substantial progress in HIV prevention and treatment, yet HIV prevalence remains unevenly distributed across the country. Sub-national estimates are needed to guide targeted interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed individual-level HIV biomarker data from the 2016 Malawi Demographic and Health Survey. A spatial modeling approach was applied to capture broad geographic patterns alongside sociodemographic determinants. High-resolution maps of predicted HIV prevalence were generated to visualize fine-scale differences across districts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The analysis revealed persistent geographic disparities, with the highest prevalence concentrated in southern Malawi and more varied patterns in central and northern regions. Although geography contributed to explaining HIV variation, sociodemographic factors\u2014including age, education, sex, and household characteristics\u2014were the primary drivers in most districts. Geography emerged as the leading contributor in only 18% of areas.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion and Conclusion<\/jats:title>\n                    <jats:p>These findings provide policy-relevant, sub-national evidence to support more precise targeting of HIV prevention, testing, and treatment efforts. They underscore the importance of tailoring interventions to both geographic and sociodemographic contexts to accelerate progress toward epidemic control.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fepid.2026.1867778","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T05:57:00Z","timestamp":1783490220000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Spatial modeling of HIV prevalence in Malawi using generalized additive models"],"prefix":"10.3389","volume":"6","author":[{"given":"Zacharie","family":"Tsala Dimbuene","sequence":"first","affiliation":[{"name":"School of Population and Development Sciences, University of Kinshasa, Kinshasa","place":["Democratic Republic of Congo"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Crispin","family":"Mabika Mabika","sequence":"additional","affiliation":[{"name":"Faculty of Economics and Management, University of Kinshasa, Kinshasa","place":["Democratic Republic of Congo"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blandine","family":"Bawawana Bavwidinsi","sequence":"additional","affiliation":[{"name":"Faculty of Economics and Management, University of Kinshasa, Kinshasa","place":["Democratic Republic of Congo"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Juakaly Wayisovia","sequence":"additional","affiliation":[{"name":"Faculty of Economics and Management, Official University of Semuliki, Beni, Democratic Republic of Congo"},{"name":"Union for African Population Studies","place":["Accra, Ghana"]},{"name":"Observartoire Fran\u00e7ais des Conjonctures Economiques (OFCE)","place":["Paris, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugues","family":"Sampasa-Kanyinga","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Kinshasa, Kinshasa","place":["Democratic Republic of Congo"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,8]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"938","DOI":"10.1186\/s12889-016-3620-x","article-title":"Act local, think global: how the Malawi experience of scaling up antiretroviral treatment has informed global policy","volume":"16","author":"Harries","year":"2016","journal-title":"BMC Public Health"},{"key":"B2","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1186\/s12963-015-0055-z","article-title":"Mapping HIV prevalence using population and antenatal sentinel-based HIV surveys: a multi-stage approach","volume":"13","author":"Manda","year":"2015","journal-title":"Popul Health Metr"},{"key":"B3","doi-asserted-by":"publisher","first-page":"e016880","DOI":"10.1136\/bmjgh-2024-016880","article-title":"A health systems approach to more effective decentralised HIV prevention: development of Malawi\u2019s blantyre prevention strategy","volume":"10","author":"Kawalazira","year":"2025","journal-title":"BMJ Glob Health"},{"key":"B4","doi-asserted-by":"publisher","first-page":"e0002437","DOI":"10.1371\/journal.pgph.0002437","article-title":"Re-engagement and retention in HIV care after preventive default tracking in a cohort of HIV-infected patients in rural Malawi: a mixed-methods study","volume":"4","author":"Suffrin","year":"2024","journal-title":"PLOS Glob Public Health"},{"key":"B5","doi-asserted-by":"publisher","first-page":"879","DOI":"10.1186\/s12982-025-01296-w","article-title":"Sustaining HIV gains towards the UNAIDS 95 95 95 targets amid a shifting funding landscape in sub Saharan Africa","volume":"22","author":"Olpengs","year":"2025","journal-title":"Discov Public Health"},{"key":"B6","doi-asserted-by":"publisher","first-page":"e0272405","DOI":"10.1371\/journal.pone.0272405","article-title":"Achieving the 95 95 95 targets for all: a pathway to ending AIDS","volume":"17","author":"Frescura","year":"2022","journal-title":"PLoS One"},{"key":"B7","doi-asserted-by":"publisher","first-page":"e597","DOI":"10.1016\/S2352-3018(23)00144-3","article-title":"Trends in HIV prevalence, incidence, and progress towards the UNAIDS 95-95-95 targets in Malawi among individuals aged 1564 years: population-based HIV impact assessments, 2015\u201316 and 2020\u201321","volume":"10","author":"Payne","year":"2023","journal-title":"Lancet HIV"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.4081\/gh.2022.1084","article-title":"Assessing spatial patterns of HIV prevalence and interventions in semi-urban settings in South Africa. 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