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2014 ; 29
(7
): 938-49
Nephropedia Template TP
gab.com Text
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English Wikipedia
What lies behind gender inequalities in HIV/AIDS in sub-Saharan African
countries: evidence from Kenya, Lesotho and Tanzania
#MMPMID24345343
Sia D
; Onadja Y
; Nandi A
; Foro A
; Brewer T
Health Policy Plan
2014[Oct]; 29
(7
): 938-49
PMID24345343
show ga
Within sub-Saharan Africa, women are disproportionately at risk for acquiring and
having human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome
(AIDS). It is important to clarify whether gender inequalities in HIV prevalence
in this region are explained by differences in the distributions of HIV risk
factors, differences in the effects of these risk factors or some combination of
both. We used an extension of the Blinder-Oaxaca decomposition approach to
explain gender inequalities in HIV/AIDS in Kenya, Lesotho and Tanzania using data
from the demographic and health and AIDS indicator surveys. After adjusting for
covariates using Poisson regression models, female gender was associated with a
higher prevalence of HIV/AIDS in Kenya [prevalence ratio (PR) = 1.73, 95%
confidence interval (CI) = 1.33, 2.23 in 2003] and Lesotho (PR = 1.39, 95% CI =
1.20, 1.62 in 2004/05), but not in Tanzania. Decomposition analyses demonstrated
two distinct patterns over time. In Tanzania, the gender inequality in HIV/AIDS
was explained by differences in the distributions of HIV risk factors between men
and women. In contrast, in Kenya and Lesotho, this inequality was partly
explained by differences in the effects across men and women of measured HIV/AIDS
risk factors, including socio-demographic characteristics (age and marital
status) and sexual behaviours (age at first sex); these results imply that gender
inequalities in HIV/AIDS would persist in Kenya and Lesotho even if men and women
had similar distributions of HIV risk factors. The production of gender
inequalities may vary across countries, with inequalities attributable to the
unequal distribution of risk factors among men and women in some countries and
the differential effect of these factors between groups in others. These
different patterns have important implications for policies to reduce gender
inequalities in HIV/AIDS.