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Background  The geographic overlap between HIV-1 and malaria has generated much interest in their potential interactions. A variety of studies have evidenced a complex HIV-malaria interaction within individuals and populations that may have dramatic effects, but the causes and implications of this co-infection at the population level are still unclear. In a previous publication, we showed that the prevalence of malaria caused by the parasite  Plasmodium falciparum  is associated with HIV infection in eastern sub-Saharan Africa. To complement our knowledge of the HIV-malaria co-infection, the objective of this work was to assess the relationship between malaria and HIV prevalence in the western region of sub-Saharan Africa.    Methodology/Principal Findings  Population-based cross-sectional data were obtained from the HIV/AIDS Demographic and Health Surveys conducted in Burkina Faso, Ghana, Guinea, Mali, Liberia and Cameroon, and the malaria atlas project. Using generalized linear mixed models, we assessed the relationship between HIV-1 and  Plasmodium falciparum  parasite rate ( Pf PR) adjusting for important socio-economic and biological cofactors. We found no evidence that individuals living in areas with stable malaria transmission ( Pf PR>0.46) have higher odds of being HIV-positive than individuals who live in areas with  Pf PR≤0.46 in western sub-Saharan Africa (estimated odds ratio 1.14, 95% confidence interval 0.86–1.50). In contrast, the results suggested that  Pf PR was associated with being infected with HIV in Cameroon (estimated odds ratio 1.56, 95% confidence interval 1.23–2.00).    Conclusion/Significance  Contrary to our previous research on eastern sub-Saharan Africa, this study did not identify an association between  Pf PR and infection with HIV in western sub-Saharan Africa, which suggests that malaria might not play an important role in the spread of HIV in populations where the HIV prevalence is low. Our work highlights the importance of understanding the epidemiologic effect of co-infection and the relevant factors involved in this relationship for the implementation of effective control strategies.

No Evidence of Association between HIV-1 and Malaria in Populations with Low HIV-1 Prevalence