TY - JOUR
T1 - Mapping age- and sex-specific HIV prevalence in adults in sub-Saharan Africa, 2000–2018
AU - on behalf of Local Burden of Disease sub-Saharan Africa HIV Prevalence Collaborators
AU - Haeuser, Emily
AU - Serfes, Audrey L.
AU - Cork, Michael A.
AU - Yang, Mingyou
AU - Abbastabar, Hedayat
AU - Abhilash, E. S.
AU - Adabi, Maryam
AU - Adebayo, Oladimeji M.
AU - Adekanmbi, Victor
AU - Adeyinka, Daniel Adedayo
AU - Afzal, Saira
AU - Ahinkorah, Bright Opoku
AU - Ahmadi, Keivan
AU - Ahmed, Muktar Beshir
AU - Akalu, Yonas
AU - Akinyemi, Rufus Olusola
AU - Akunna, Chisom Joyqueenet
AU - Alahdab, Fares
AU - Alanezi, Fahad Mashhour
AU - Alanzi, Turki M.
AU - Alene, Kefyalew Addis
AU - Alhassan, Robert Kaba
AU - Alipour, Vahid
AU - Almasi-Hashiani, Amir
AU - Alvis-Guzman, Nelson
AU - Ameyaw, Edward Kwabena
AU - Amini, Saeed
AU - Amugsi, Dickson A.
AU - Ancuceanu, Robert
AU - Anvari, Davood
AU - Appiah, Seth Christopher Yaw
AU - Arabloo, Jalal
AU - Aremu, Olatunde
AU - Asemahagn, Mulusew A.
AU - Jafarabadi, Mohammad Asghari
AU - Awedew, Atalel Fentahun
AU - Quintanilla, Beatriz Paulina Ayala
AU - Ayanore, Martin Amogre
AU - Aynalem, Yared Asmare
AU - Azari, Samad
AU - Azene, Zelalem Nigussie
AU - Darshan, B. B.
AU - Babalola, Tesleem Kayode
AU - Baig, Atif Amin
AU - Banach, Maciej
AU - Bärnighausen, Till Winfried
AU - Bell, Arielle Wilder
AU - Bhagavathula, Akshaya Srikanth
AU - Bhardwaj, Nikha
AU - Kumar, Manasi
N1 - Publisher Copyright:
© 2022, The Author(s).
PY - 2022/12
Y1 - 2022/12
N2 - Background: Human immunodeficiency virus and acquired immune deficiency syndrome (HIV/AIDS) is still among the leading causes of disease burden and mortality in sub-Saharan Africa (SSA), and the world is not on track to meet targets set for ending the epidemic by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the United Nations Sustainable Development Goals (SDGs). Precise HIV burden information is critical for effective geographic and epidemiological targeting of prevention and treatment interventions. Age- and sex-specific HIV prevalence estimates are widely available at the national level, and region-wide local estimates were recently published for adults overall. We add further dimensionality to previous analyses by estimating HIV prevalence at local scales, stratified into sex-specific 5-year age groups for adults ages 15–59 years across SSA. Methods: We analyzed data from 91 seroprevalence surveys and sentinel surveillance among antenatal care clinic (ANC) attendees using model-based geostatistical methods to produce estimates of HIV prevalence across 43 countries in SSA, from years 2000 to 2018, at a 5 × 5-km resolution and presented among second administrative level (typically districts or counties) units. Results: We found substantial variation in HIV prevalence across localities, ages, and sexes that have been masked in earlier analyses. Within-country variation in prevalence in 2018 was a median 3.5 times greater across ages and sexes, compared to for all adults combined. We note large within-district prevalence differences between age groups: for men, 50% of districts displayed at least a 14-fold difference between age groups with the highest and lowest prevalence, and at least a 9-fold difference for women. Prevalence trends also varied over time; between 2000 and 2018, 70% of all districts saw a reduction in prevalence greater than five percentage points in at least one sex and age group. Meanwhile, over 30% of all districts saw at least a five percentage point prevalence increase in one or more sex and age group. Conclusions: As the HIV epidemic persists and evolves in SSA, geographic and demographic shifts in prevention and treatment efforts are necessary. These estimates offer epidemiologically informative detail to better guide more targeted interventions, vital for combating HIV in SSA.
AB - Background: Human immunodeficiency virus and acquired immune deficiency syndrome (HIV/AIDS) is still among the leading causes of disease burden and mortality in sub-Saharan Africa (SSA), and the world is not on track to meet targets set for ending the epidemic by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the United Nations Sustainable Development Goals (SDGs). Precise HIV burden information is critical for effective geographic and epidemiological targeting of prevention and treatment interventions. Age- and sex-specific HIV prevalence estimates are widely available at the national level, and region-wide local estimates were recently published for adults overall. We add further dimensionality to previous analyses by estimating HIV prevalence at local scales, stratified into sex-specific 5-year age groups for adults ages 15–59 years across SSA. Methods: We analyzed data from 91 seroprevalence surveys and sentinel surveillance among antenatal care clinic (ANC) attendees using model-based geostatistical methods to produce estimates of HIV prevalence across 43 countries in SSA, from years 2000 to 2018, at a 5 × 5-km resolution and presented among second administrative level (typically districts or counties) units. Results: We found substantial variation in HIV prevalence across localities, ages, and sexes that have been masked in earlier analyses. Within-country variation in prevalence in 2018 was a median 3.5 times greater across ages and sexes, compared to for all adults combined. We note large within-district prevalence differences between age groups: for men, 50% of districts displayed at least a 14-fold difference between age groups with the highest and lowest prevalence, and at least a 9-fold difference for women. Prevalence trends also varied over time; between 2000 and 2018, 70% of all districts saw a reduction in prevalence greater than five percentage points in at least one sex and age group. Meanwhile, over 30% of all districts saw at least a five percentage point prevalence increase in one or more sex and age group. Conclusions: As the HIV epidemic persists and evolves in SSA, geographic and demographic shifts in prevention and treatment efforts are necessary. These estimates offer epidemiologically informative detail to better guide more targeted interventions, vital for combating HIV in SSA.
KW - Africa
KW - Demographics
KW - Geostatistics
KW - HIV
KW - HIV prevalence
KW - Mapping
KW - Spatial statistics
UR - http://www.scopus.com/inward/record.url?scp=85144401013&partnerID=8YFLogxK
U2 - 10.1186/s12916-022-02639-z
DO - 10.1186/s12916-022-02639-z
M3 - Article
C2 - 36529768
AN - SCOPUS:85144401013
SN - 1741-7015
VL - 20
JO - BMC Medicine
JF - BMC Medicine
IS - 1
M1 - 488
ER -