{"doi":"10.1101/126052","title":"Systematic Identification of Correlates of HIV-1 Infection: An X-Wide Association Study in Zambia","abstract":"<h4>Background</h4> HIV-1 remains the leading cause of death among adults in Sub-Saharan Africa, and over 1 million people are infected annually. Better identification of at-risk groups could benefit prevention and treatment programmes. We systematically identified factors related to HIV-1 infection in two nationally representative cohorts of women that participated in Zambia’s Demographic and Health Surveys (DHS). <h4>Methods</h4> We conducted a comprehensive analysis to identify and replicate the association of 1,415 social, economic, environmental, and behavioral indicators with HIV-1 status. We used the 2007 and 2013-2014 DHS surveys conducted among 5,715 and 15,433 Zambian women, respectively (727 indicators in 2007; 688 in 2013-2014; 688 in both). We used false discovery rate criteria to identify indicators that are strongly associated with HIV-1 in univariate and multivariate models in the entire population, as well as in subgroups stratified by wealth, residence, age, and history of HIV-1 testing. <h4>Findings</h4> In the univariate analysis we identified 102 and 182 variables that are associated with HIV-1 in the 2007 and 2013-2014 surveys, respectively, among which 79 were associated in both. Variables that were associated with HIV-1 status in all full-sample models (unadjusted and adjusted) as well as in at least 17 out of 18 subgroups include being formerly in a union (adjusted OR 2007 2.8, p<10 −16 ; 2013-2014 2.8, p<10 −29 ), widowhood (adjusted OR 2007 3.7, p<10 −12 ; 2013-2014 4.2, p<10 −30 ), history of genital ulcers in the last 12 months (adjusted 2007 OR 2.4, p<10 −5 ; 2013-2014 2.2, p<10 −6 ), and having a woman for the head of the household (2007 OR 1.7, p<10 −7 ; 2013-2014 OR 2.1, p<10 −26 ), while owning a bicycle (adjusted 2007 OR 0.6, p<10 −6 ; 2013-2014 0.6, p<10 −8 ) and currently breastfeeding (adjusted 2007 OR 0.5, p<10 −9 ; 2013-2014 0.4, p<10 −26 ) were associated with decreased risk. Using the identified variables, area under the curve for HIV-1 positivity ranged from 0.76 to 0.82. <h4>Interpretation</h4> Our X-wide association study in Zambian women identifies multiple under-recognized factors correlated with HIV-1 infection in 2007 and 2013-2014, including widowhood, breastfeeding, and being the head of the household. These variables could be used to improve HIV-1 testing and identification programs.","journal":"bioRxiv (Cold Spring Harbor Laboratory)","year":2017,"id":12211,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.2064,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2017-04-10","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":34866,"name":"Jay Bhattacharya","orcid":"0000-0003-3867-3174","position":1,"is_corresponding":false},{"id":11482,"name":"Eran Bendavid","orcid":"0000-0002-8364-4711","position":3,"is_corresponding":false},{"id":148,"name":"John P. A. Ioannidis","orcid":"0000-0003-3118-6859","position":4,"is_corresponding":false},{"id":833,"name":"Chirag J. Patel","orcid":"0000-0002-8756-8525","position":0,"is_corresponding":true}],"reference_count":34,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-03-01T18:20:47.508186Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}