B A model for risk group proportions

B.1 The Global AIDS Strategy

Table B.1: Prioritisation strata for AGYW given by UNAIDS (2021b) based on to HIV incidence in the general population and behavioural risk.

Prioritisation strata	Criterion
Low	0.3-1.0% incidence and low-risk behaviour, or <0.3% incidence and high-risk behaviour
Moderate	1.0-3.0% incidence and low-risk behaviour, or 0.3-1.0% incidence and high-risk behaviour
High	1.0-3.0% incidence and high-risk behaviour
Very high	>3.0% incidence

Table B.2: Commitments recommended by UNAIDS (2021b) to be met for each HIV intervention, given in terms of the proportion of the AGYW prioritisation strata reached. The symbol “-” represents no commitment.

Intervention	Low	Moderate	High	Very High
Condoms and lube for those with non-regular partners(s), unknown STI status, not on PrEP	50%	70%	95%	95%
STI screening and treatment	10%	10%	80%	80%
Access to PEP	-	-	50%	90%
PrEP use	-	5%	50%	50%
Economic empowerment	-	-	20%	20%

B.2 Household survey data

Table B.3: The sample size by age group for each included survey in the analysis. The column “TS question” refers to whether or not the survey included a specific question about transactional sex (TS).

	Type	Year	TS question	Sample size
				15-19	20-24	25-29	Total
Botswana
	BAIS	2013	✓	557	588	649	1794
Cameroon
	DHS	2004	✗	2678	2210	1732	6620
	DHS	2011	✗	3588	3115	2656	9359
	PHIA	2017	✗	2140	1923	1851	5914
	DHS	2018	✓	3349	2463	2345	8157
Kenya
	DHS	2003	✗	1819	1709	1391	4919
	DHS	2008	✗	1767	1743	1420	4930
	DHS	2014	✗	2861	2534	2858	8253
Lesotho
	DHS	2004	✗	1761	1456	1026	4243
	DHS	2009	✗	1834	1545	1195	4574
	DHS	2014	✗	1537	1293	1069	3899
	PHIA	2017	✓	1156	1202	1054	3412
Mozambique
	AIS	2009	✗	1031	1106	987	3124
	DHS	2011	✗	3065	2468	2340	7873
	AIS	2015	✗	1554	1390	1080	4024
Malawi
	DHS	2000	✗	2914	2998	2358	8270
	DHS	2004	✗	2407	2823	2135	7365
	DHS	2010	✗	5032	4387	4309	13728
	DHS	2015	✓	5273	5094	3976	14343
	PHIA	2016	✓	1646	1934	1511	5091
Namibia
	DHS	2000	✗	1428	1313	1099	3840
	DHS	2006	✗	2203	1870	1544	5617
	DHS	2013	✗	1852	1709	1482	5043
	PHIA	2017	✓	1491	1525	1370	4386
Eswatini
	DHS	2006	✗	1265	1027	731	3023
	PHIA	2017	✗	1031	895	811	2737
Tanzania
	AIS	2003	✗	1466	1377	1270	4113
	AIS	2007	✗	2137	1676	1509	5322
	DHS	2010	✗	2221	1860	1613	5694
	AIS	2012	✗	2474	1923	1815	6212
Uganda
	DHS	2000	✗	1687	1541	1326	4554
	DHS	2006	✗	1948	1661	1406	5015
	AIS	2011	✗	2451	2164	1921	6536
	DHS	2011	✗	2025	1664	1614	5303
	DHS	2016	✓	4276	3782	3014	11072
	PHIA	2016	✗	3289	3059	2574	8922
South Africa
	DHS	2016	✓	1505	1408	1397	4310
Zambia
	DHS	2007	✗	1598	1405	1373	4376
	DHS	2013	✗	3685	3036	2789	9510
	PHIA	2016	✓	2120	2045	1619	5784
	DHS	2018	✓	3112	2687	2166	7965
Zimbabwe
	DHS	1999	✗	1468	1230	1011	3709
	DHS	2005	✗	2128	1943	1438	5509
	DHS	2010	✗	1966	1796	1680	5442
	DHS	2015	✓	2154	1779	1647	5580
	PHIA	2016	✓	2114	1817	1573	5504
Total				103063	92173	79734	274970

Table B.4: All of that household surveys that were excluded from the risk group model in Section 5.3.

Survey	Reason for exclusion
Mozambique 2003 DHS	No GPS coordinates available to place survey clusters within districts.
Tanzania 2015 DHS	Insufficient sexual behaviour questions.
Uganda 2004 AIS	Unable to download region boundaries.
Zambia 2002 DHS	No GPS coordinates available to place survey clusters within districts.

B.3 Spatial analysis levels

Table B.5: The number of areas and analysis level for each country that was used in the analysis.

Country	Number of areas	Analysis level
Botswana	27	Health district
Cameroon	58	Department
Kenya	47	County
Lesotho	10	District
Mozambique	161	District
Malawi	33	Health district and cities
Namibia	38	District
Eswatini	4	Region
Tanzania	195	District
Uganda	136	District
South Africa	52	District
Zambia	116	District
Zimbabwe	63	District

B.4 Survey questions and risk group allocation

Table B.6: The behavioural survey questions included in AIDS Indicator Survey (AIS) and Demographic and Health Surveys (DHS) used to determine AGYW risk group membership.

Variable(s)	Description
\(\texttt{v501}\)	Current marital status of the respondent.
\(\texttt{v529}\)	Computed time since last sexual intercourse.
\(\texttt{v531}\)	Age at first sexual intercourse–imputed.
\(\texttt{v766b}\)	Number of sexual partners during the last 12 months (including husband).
\(\texttt{v767[a, b, c]}\)	Relationship with last three sexual partners. Options are: spouse, boyfriend not living with respondent, other friend, casual acquaintance, relative, commercial sex worker, live-in partner, other.
\(\texttt{v791a}\)	Had sex in return for gifts, cash or anything else in the past 12 months. (Asked only to women 15-24 who are not in a union.)

Table B.7: The behavioural survey questions included in Population-Based HIV Impact Assessment (PHIA) surveys used to determine AGYW risk group membership.

Variable(s)	Description
\(\texttt{part12monum}\)	Number of sexual partners during the last 12 months (including husband).
\(\texttt{part12modkr}\)	Reason for leaving blank.
\(\texttt{partlivew[1, 2, 3]}\)	Does the person you had sex with live in this household?
\(\texttt{partrelation[1, 2, 3]}\)	Relationship with last three sexual partners. Options are: husband, live-in partner, partner (not living with), ex-spouse/partner, friend/acquaintance, sex worker, sex worker client, stranger, other, don’t know, refused.
\(\texttt{sellsx12mo}\)	Had sex for money and/or gifts in the last 12 months.
\(\texttt{buysx12mo}\)	Paid money or given gifts for sex in the last 12 months.

B.5 Additional figures

Figure B.1: The proportion of posterior variance explained by each random effect, calculated as a ratio of the random effect variance posterior mean to the sum of all random effect variance posterior means. To allow calculation of this metric by country, the model was run for each country individually.

Figure B.2: For the 20-24 and 25-29 age groups, the proportion of AGYW in the one cohabiting partner and non-regular or multiple partner(s) risk groups was bimodal.

References

UNAIDS. 2021b. “Global AIDS strategy 2021–2026. End inequalities. End AIDS.”