Assessing regional variations and sociodemographic barriers in the progress toward UNAIDS 95-95-95 targets in Zimbabwe

Abstract Background The HIV/AIDS epidemic remains critical in sub-Saharan Africa, with UNAIDS establishing “95-95-95” targets to optimize HIV care. Using the 2020 Zimbabwe Population-based HIV Impact Assessment (ZIMPHIA) geospatial data, this study aimed to identify patterns in these targets and det...

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Main Authors: MD Tuhin Chowdhury, Anna Bershteyn, Masabho Milali, Daniel T. Citron, Sulani Nyimbili, Godfrey Musuka, Diego F. Cuadros
Format: Article
Language:English
Published: Nature Portfolio 2025-04-01
Series:Communications Medicine
Online Access:https://doi.org/10.1038/s43856-025-00824-8
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author MD Tuhin Chowdhury
Anna Bershteyn
Masabho Milali
Daniel T. Citron
Sulani Nyimbili
Godfrey Musuka
Diego F. Cuadros
author_facet MD Tuhin Chowdhury
Anna Bershteyn
Masabho Milali
Daniel T. Citron
Sulani Nyimbili
Godfrey Musuka
Diego F. Cuadros
author_sort MD Tuhin Chowdhury
collection DOAJ
description Abstract Background The HIV/AIDS epidemic remains critical in sub-Saharan Africa, with UNAIDS establishing “95-95-95” targets to optimize HIV care. Using the 2020 Zimbabwe Population-based HIV Impact Assessment (ZIMPHIA) geospatial data, this study aimed to identify patterns in these targets and determinants impacting the HIV care continuum in underserved Zimbabwean communities. Methods Analysis techniques, including Gaussian kernel interpolation, optimized hotspot, and multivariate geospatial k-means clustering, were utilized to establish spatial patterns and cluster regional HIV care continuum needs. Further, we investigated healthcare availability, access, and social determinants and scrutinized the association between socio-demographic and behavioral covariates with HIV care outcomes. Results Disparities in progress toward the “95-95-95” targets were noted across different regions, with each target demonstrating unique geographic patterns, resulting in four distinct clusters with specific HIV care needs. Key factors associated with gaps in achieving targets included younger age, male gender, employment, and minority or no religious affiliation. Conclusions Our study uncovers significant spatial heterogeneity in the HIV care continuum in Zimbabwe, with unique regional patterns in “95-95-95” targets. The spatial analysis of the UNAIDS targets presented here could prove instrumental in designing effective control strategies by identifying vulnerable communities that are falling short of these targets and require intensified efforts. We provide insights for designing region-specific interventions and enhancing community-level factors, emphasizing the need to address regional gaps and improve HIV care outcomes in vulnerable communities that lag behind.
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spelling doaj-art-5d4e360ef7a945139d7e478f9f714df02025-08-20T02:17:02ZengNature PortfolioCommunications Medicine2730-664X2025-04-015111110.1038/s43856-025-00824-8Assessing regional variations and sociodemographic barriers in the progress toward UNAIDS 95-95-95 targets in ZimbabweMD Tuhin Chowdhury0Anna Bershteyn1Masabho Milali2Daniel T. Citron3Sulani Nyimbili4Godfrey Musuka5Diego F. Cuadros6Digital Epidemiology Laboratory, Digital Futures, University of CincinnatiDepartment of Population Health, New York University Grossman School of MedicineDepartment of Population Health, New York University Grossman School of MedicineDepartment of Population Health, New York University Grossman School of MedicineDepartment of Population Health, New York University Grossman School of MedicineInternational Initiative for Impact EvaluationDigital Epidemiology Laboratory, Digital Futures, University of CincinnatiAbstract Background The HIV/AIDS epidemic remains critical in sub-Saharan Africa, with UNAIDS establishing “95-95-95” targets to optimize HIV care. Using the 2020 Zimbabwe Population-based HIV Impact Assessment (ZIMPHIA) geospatial data, this study aimed to identify patterns in these targets and determinants impacting the HIV care continuum in underserved Zimbabwean communities. Methods Analysis techniques, including Gaussian kernel interpolation, optimized hotspot, and multivariate geospatial k-means clustering, were utilized to establish spatial patterns and cluster regional HIV care continuum needs. Further, we investigated healthcare availability, access, and social determinants and scrutinized the association between socio-demographic and behavioral covariates with HIV care outcomes. Results Disparities in progress toward the “95-95-95” targets were noted across different regions, with each target demonstrating unique geographic patterns, resulting in four distinct clusters with specific HIV care needs. Key factors associated with gaps in achieving targets included younger age, male gender, employment, and minority or no religious affiliation. Conclusions Our study uncovers significant spatial heterogeneity in the HIV care continuum in Zimbabwe, with unique regional patterns in “95-95-95” targets. The spatial analysis of the UNAIDS targets presented here could prove instrumental in designing effective control strategies by identifying vulnerable communities that are falling short of these targets and require intensified efforts. We provide insights for designing region-specific interventions and enhancing community-level factors, emphasizing the need to address regional gaps and improve HIV care outcomes in vulnerable communities that lag behind.https://doi.org/10.1038/s43856-025-00824-8
spellingShingle MD Tuhin Chowdhury
Anna Bershteyn
Masabho Milali
Daniel T. Citron
Sulani Nyimbili
Godfrey Musuka
Diego F. Cuadros
Assessing regional variations and sociodemographic barriers in the progress toward UNAIDS 95-95-95 targets in Zimbabwe
Communications Medicine
title Assessing regional variations and sociodemographic barriers in the progress toward UNAIDS 95-95-95 targets in Zimbabwe
title_full Assessing regional variations and sociodemographic barriers in the progress toward UNAIDS 95-95-95 targets in Zimbabwe
title_fullStr Assessing regional variations and sociodemographic barriers in the progress toward UNAIDS 95-95-95 targets in Zimbabwe
title_full_unstemmed Assessing regional variations and sociodemographic barriers in the progress toward UNAIDS 95-95-95 targets in Zimbabwe
title_short Assessing regional variations and sociodemographic barriers in the progress toward UNAIDS 95-95-95 targets in Zimbabwe
title_sort assessing regional variations and sociodemographic barriers in the progress toward unaids 95 95 95 targets in zimbabwe
url https://doi.org/10.1038/s43856-025-00824-8
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