Characterization of spatial and temporal transmission of HIV infection in Surabaya, Indonesia: Geographic information system (GIS) cluster detection analysis (2016-2020).

The high prevalence of human immunodeficiency virus (HIV) infections has become a devastating public health problem in Indonesia. In response, the government has taken measures to reduce the transmission of HIV and the number of deaths from HIV/acquired immunodeficiency syndrome (AIDS). However, these efforts have not successfully reduced the spread of HIV in Surabaya. In this study, we analyzed the factors that could influence the spread of HIV in Surabaya using a Geographic Information System. We conducted a spatial analysis of HIV/AIDS clusters in Surabaya from 2016 to 2020. Spatial autocorrelation and spatiotemporal analysis were used to identify local HIV clustering. In addition, the Global Moran's index was applied to detect HIV clustering at the sub-district level. The results showed that HIV mostly occurred among males (683/969; 70.3%) in the economic age group (20-35 years) and that the infection was transmitted mostly through sexual intercourse (942/969; 97.2%). The hotspots were located in Central and Southern Surabaya, including the Genteng, Tegal Sari, Gubeng, and Sawahan sub-sub-districts. Western Surabaya (Benowo and Pakal) was the only hot spot in 2018. In conclusion, the spatial and temporal analysis of HIV, coupled with an assessment of the factors that drive the epidemic, can assist the government to formulate policies and design targeted interventions to prevent and control the epidemic in Surabaya, Indonesia.