The Geography of HIV/AIDS infection in Botswana

Ngianga-Bakwin Kandala, University of Warwick
Eugene Campbell, University of Botswana
Serai D. Rakgoasi, University of the Witwatersrand
Banyana Madi, SADC
Thabo Fako, University of Botswana

Botswana’s HIV/AIDS epidemic is unprecedented in magnitude and impact. For two decades starting during the early 1990s, HIV infection rates in this country of less than two million people have grown tremendously. While the impact of HIV/AIDS is clear for all to see, for a number of years, estimating the population based HIV prevalence rate was challenging due to absence of data. Most estimates of HIV prevalence relied on sentinel surveillance of pregnant women attending antenatal care. A Bayesian geo-additive mixed model based on Markov Chain Monte Carlo techniques was used to map the geographic distribution of HIV/AIDS prevalence at the 26 districts, accounting for important risk factors using the 2008 Botswana AIDS Impact Survey. HIV prevalence was 17.6%, higher among females and in cities and town but lower among professionals. The study shows a clear geographic distribution of the HIV/AIDS epidemic with highest prevalence in the east-central districts.