Abstract
BACKGROUND: Although promising effort has been made so far, HIV remains a public health concern. Women in Ethiopia are disproportionately affected by HIV, accounting for a majority of new infections and HIV -related deaths. However, the geospatial distribution of HIV among women in Ethiopia is not well understood, making it challenging to develop geographically targeted measures. Besides, to accelerate the pathway of decreasing HIV prevalence and plan geographically specific interventions, understanding the geospatial distribution of HIV seropositivity among women plays a crucial role. METHODS: A spatial analysis was conducted among 14,778 weighted samples of women in the reproductive age group. Global Moran's I was computed to determine whether HIV seropositivity is randomly distributed, clustered, or dispersed. Getis-Ord Gi* spatial statistic was done to identify spatial clusters of cold and hot spot areas. RESULTS: HIV seropositivity among women in Ethiopia is distributed non-randomly (Global Moran's I = 0.16). The distribution of HIV ranges from 0.02 % to 6.16 %. A hotspot clustering of HIV seropositivity was identified in Addis Ababa, Harari, Dire Dawa, and Gambela region. Women residing in the primary cluster, encompassing Addis Ababa, Harari, and Dire Dawa, exhibited a substantially increased risk of HIV infection compared to the reverse group (LLR = 32.88, 95CI:26.33-39.36). CONCLUSION: HIV seropositivity among women in Ethiopia is unevenly distributed, with clear spatial clustering. The highest concentration of cases was identified in Addis Ababa, Harari, Dire Dawa, and Gambela, with significantly elevated risk observed in the primary cluster regions. These findings underscore the importance of geographically targeted interventions to address the concentrated burden of HIV in high-risk regions.