Although there are signs that the HIV/AIDS epidemic is stabilizing or has started to decline in a number of countries in sub-Saharan Africa, the actual number of people infected continues to grow due to new infections and use of antiretroviral drugs. This calls for continued efforts to improve understanding of factors associated with HIV infection in the region. In this paper, we apply three level logistic regression models to recent Demographic and Health Surveys data across 20 countries of sub-Saharan Africa to examine the determinants and cross national variation in the risk of HIV infection in the region. The analyses include individual level and contextual region/country level risk factors which are introduced to the models in successive stages to identify potential pathways of the determinants.
Simultaneous confidence intervals of country-level residuals are used to compare the risk of HIV infection across countries, after controlling for specific sets of covariates. The study reveals interesting general patterns in the risk of HIV infection across countries in sub-Saharan Africa. In particular, the findings highlight the gender disparity in socio-economic risk factors of HIV infection, partly explained by sexual behaviour factors. Besides providing a general picture of overall patterns in the risk of HIV infection across sub-Saharan Africa, useful for informing international efforts, the study identifies specific areas for in-depth investigation that would provide findings useful for informing national efforts aimed at addressing the HIV/AIDS epidemic across countries in the region.