Spatiotemporal Analysis of HIV Incidence in Sindh, Pakistan: A District-Wise Study (2021–2024) Using Getis-Ord Gi*

Abstract

This study identifies the geographic clustering of HIV incidence and its changes over time within the districts of Sindh during 2021 - 2024. This study has some limitations, firstly, only public sector diagnosis cases of HIV have been used because of the inaccessibility of private sector. Secondly, the population estimates applied throughout the years may affect the accuracy of the incidence rate. Human Immunodeficiency Virus has become one of the remains a major problem for global public health. The number of new HIV cases has increased significantly over the past 15 years. In Sindh, districts differ in terms of socioeconomic conditions, access to healthcare, and unsafe medical practices. The district level data on HIV diagnosed cases were collected from the Sindh Bureau of Statistics. Spatial autocorrelation methods were applied to derive the findings. Global Moran’s I was used to evaluate spatial autocorrelation, while Getis-Ord Gi was utilized to pinpoint areas with high and low incidence rates. The study finds the significant spatial clustering between 2021 and 2023 (Moran's I > 0.29, p < 0.01). By 2024, spatial clustering became less significant, indicating wider spread across districts. Jacobabad, Larkana and Shikarpur districts were continuously classified as hot spots. While Badin, Sujawal, and Mirpur Khas appeared as cold spots. These findings may be helpful for policymakers to understand the dynamics of HIV spread and enable more targeted and effective public health interventions.