Using factor analyses to estimate the number of female sex workers across Malawi from multiple regional sources

Xiaoyue Maggie Niu, Amrita Rao, David Chen, Ben Sheng, Sharon Weir, Eric Umar, Gift Trapence, Vincent Jumbe, Dunker Kamba, Katherine Rucinski, Nikita Viswasam, Stefan Baral, Le Bao

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Purpose: Human immunodeficiency virus (HIV) risks are heterogeneous in nature even in generalized epidemics. However, data are often missing for those at highest risk of HIV, including female sex workers. Statistical models may be used to address data gaps where direct, empiric estimates do not exist. Methods: We proposed a new size estimation method that combines multiple data sources (the Malawi Biological and Behavioral Surveillance Survey, the Priorities for Local AIDS Control Efforts study, and the Malawi Demographic Household Survey). We used factor analysis to extract information from auxiliary variables and constructed a linear mixed effects model for predicting population size for all districts of Malawi. Results: On average, the predicted proportion of female sex workers among women of reproductive age across all districts was about 0.58%. The estimated proportions seemed reasonable in comparing with a recent study Priorities for Local AIDS Control Efforts II (PLACE II). Compared with using a single data source, we observed increased precision and better geographic coverage. Conclusions: We illustrate how size estimates from different data sources may be combined for prediction. Applying this approach to other subpopulations in Malawi and to countries where size estimate data are lacking can ultimately inform national modeling processes and estimate the distribution of risks and priorities for HIV prevention and treatment programs.

Original languageEnglish (US)
Pages (from-to)34-40
Number of pages7
JournalAnnals of Epidemiology
StatePublished - Mar 2021

All Science Journal Classification (ASJC) codes

  • Epidemiology


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