Background: Extensive evidence suggests there are large variations in the prevalence of HIV
infection among Sub-Saharan African countries. Some studies associated these variations in HIV
prevalence to differences in the rate of HIV spread while others attributed the variations to risky
sexual behaviors. The purpose of this study was to examine differences in risk factors for HIV
infection between Cameroon, Cote d’Ivoire, and Senegal, to determine the association between
HIV status and risk factors within and among countries, and identify best predictive risk factors
that help explain variations in HIV prevalence.
Methods: A cross-sectional study was conducted using nationally representative data from The
Demographic and Health Surveys Program. Population-based samples of adults aged 15-49
representing 21,878 in Cameroon (2011), 14,682 in Cote d’Ivoire (2011-2012), and 20,102 in
Senegal (2010-2011) were used in the study. Descriptive analysis and binary logistic regression
were performed using IBM Statistical Package for the Social Sciences. Odds ratios and 95%
confidence interval were calculated, and models were explored.
Results: There are statistically significant (p<.001) differences in HIV risk factors between
Cameroon, Cote d’Ivoire and Senegal. More men and women were engaged in risky behaviors
including having two and more sexual partners in the last 12 months in Cameroon (9.5%) and
Cote d’Ivoire (9.3%) than men and women in Senegal (1.4%). The results of the multivariate
analysis of the association between HIV status and country indicators and risk factors showed
Cameroon at significantly greater increased odds (OR= 2.97; 2.18-4.03; p<.001) of HIV
infection than Cote d’Ivoire (OR=2.57; 1.89-3.50; p<.001) in reference to Senegal. The fact that
the country indicators are strong and significant indicates that not all the variation in HIV
prevalence is explained by the risk factors but only some of it is. Additionally, the forward LR
analysis suggests that Cote d’Ivoire has more risk factors (7) associated with HIV infection than
Cameroon (5) or Senegal does (4).
Conclusion: There are differences in risk factors among the three countries and these differences
can explain some of the variations in HIV prevalence. Further research is necessary to help
capture variations in HIV prevalence that cannot be explained by differences in risk factors.
These findings will help advance prevention efforts.