The following is a summary of “Prevalence of HIV in slums area: a systematic review and meta-analysis,” published in the January 2024 issue of Infectious Disease by Behzadifar et al.
Human Immunodeficiency Virus (HIV) remains a pressing global health concern, especially impacting vulnerable populations residing in densely populated, impoverished slum areas with limited access to healthcare services, fostering an environment conducive to HIV transmission. Despite this acknowledged issue, a comprehensive understanding of HIV prevalence in slums is lacking. This study aims to consolidate global evidence on HIV prevalence among slum populations systematically.
The researchers conducted a rigorous systematic review by searching diverse electronic databases such as Medline via PubMed, Scopus, Embase, Web of Sciences, and Directory of Open Access Journals (DOAJ) from January 1, 1990, to March 31, 2023. The study group evaluated study quality and bias using the Newcastle–Ottawa Scale. Using a random-effects model with Freeman-Tukey double arcsine transformation, they calculated pooled prevalence with its 95% CI. The I2 test assessed heterogeneity among studies, while publication bias was evaluated using Egger’s test. Additionally, subgroup analysis was conducted to explore contributing factors to observed heterogeneity.
The systematic review included 22 studies encompassing 52,802 participants. The random-effects model estimated the overall HIV prevalence in slum areas at 10% (95% CI: 7–13%). Subgroup analysis based on gender showed higher HIV prevalence among women at 13% (95% CI: 8–19%, 18 studies: I2 = 98%) compared to 8% among men (95% CI: 6–12%, 16 studies: I2 = 95%). Geographically, Africa exhibited the highest prevalence at 11% (95% CI: 9–13%, 18 studies: I2 = 98%). The American continent reported 9% prevalence (95% CI: 7–11%, 2 studies: I2 = 57%), while Asia had the lowest prevalence at 1% (95% CI: 0–3%, 2 studies: I2 = 94%). Studies using rapid tests reported 13% prevalence (95% CI: 9–17%, 6 studies: I2 = 94%), whereas self-reported data indicated 8% prevalence (95% CI: 5–11%, 6 studies: I2 = 99%). Furthermore, studies using ELISA showed a 9% prevalence (95% CI: 6–12%, 10 studies: I2 = 96%). Notably, upper-middle-income countries had a higher prevalence of 20% (95% CI: 16–24%, 5 studies: I2 = 45%), whereas lower- and middle-income countries had an 8% prevalence (95% CI: 6–10%, 12 studies: I2 = 98%).
This study highlights the alarmingly high prevalence of HIV within slum areas, stressing the need for targeted interventions to curb its spread. Policymakers should focus on implementing effective strategies to address gender disparities, alleviate poverty, and empower residents in these marginalized regions.
Source: bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-023-08877-7
