Repository of Research and Investigative Information

Repository of Research and Investigative Information

Ilam University of Medical Sciences

Global, regional, and national incidence, prevalence, and mortality of HIV, 1980-2017, and forecasts to 2030, for 195 countries and territories: a systematic analysis for the Global Burden of Diseases, Injuries, and Risk Factors Study 2017

Wed May 18 18:01:16 2022

(2019) Global, regional, and national incidence, prevalence, and mortality of HIV, 1980-2017, and forecasts to 2030, for 195 countries and territories: a systematic analysis for the Global Burden of Diseases, Injuries, and Risk Factors Study 2017. Lancet Hiv. E831-E859. ISSN 2352-3018

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Abstract

Background Understanding the patterns of HIV/AIDS epidemics is crucial to tracking and monitoring the progress of prevention and control efforts in countries. We provide a comprehensive assessment of the levels and trends of HIV/AIDS incidence, prevalence, mortality, and coverage of antiretroviral therapy (ART) for 1980-2017 and forecast these estimates to 2030 for 195 countries and territories. Methods We determined a modelling strategy for each country on the basis of the availability and quality of data. For countries and territories with data from population-based seroprevalence surveys or antenatal care clinics, we estimated prevalence and incidence using an open-source version of the Estimation and Projection Package-a natural history model originally developed by the UNAIDS Reference Group on Estimates, Modelling, and Projections. For countries with cause-specific vital registration data, we corrected data for garbage coding (ie, deaths coded to an intermediate, immediate, or poorly defined cause) and HIV misclassification. We developed a process of cohort incidence bias adjustment to use information on survival and deaths recorded in vital registration to back-calculate HIV incidence. For countries without any representative data on HIV, we produced incidence estimates by pulling information from observed bias in the geographical region. We used a re-coded version of the Spectrum model (a cohort component model that uses rates of disease progression and HIV mortality on and off ART) to produce age-sex-specific incidence, prevalence, and mortality, and treatment coverage results for all countries, and forecast these measures to 2030 using Spectrum with inputs that were extended on the basis of past trends in treatment scale-up and new infections. Findings Global HIV mortality peaked in 2006 with 1.95 million deaths (95 uncertainty interval 1.87-2.04) and has since decreased to 0.95 million deaths (0.91-1.01) in 2017. New cases of HIV globally peaked in 1999 (3.16 million, 2.79-3.67) and since then have gradually decreased to 1.94 million (1.63-2.29) in 2017. These trends, along with ART scale-up, have globally resulted in increased prevalence, with 36.8 million (34.8-39.2) people living with HIV in 2017. Prevalence of HIV was highest in southern sub-Saharan Africa in 2017, and countries in the region had ART coverage ranging from 65.7 in Lesotho to 85.7 in eSwatini. Our forecasts showed that 54 countries will meet the UNAIDS target of 81 ART coverage by 2020 and 12 countries are on track to meet 90 ART coverage by 2030. Forecasted results estimate that few countries will meet the UNAIDS 2020 and 2030 mortality and incidence targets. Interpretation Despite progress in reducing HIV-related mortality over the past decade, slow decreases in incidence, combined with the current context of stagnated funding for related interventions, mean that many countries are not on track to reach the 2020 and 2030 global targets for reduction in incidence and mortality. With a growing population of people living with HIV, it will continue to be a major threat to public health for years to come. The pace of progress needs to be hastened by continuing to expand access to ART and increasing investments in proven HIV prevention initiatives that can be scaled up to have population-level impact. Copyright (C) 2019 The Author(s). Published by Elsevier Ltd.

Item Type: Article
Creators:
CreatorsEmail
Frank, T. D.UNSPECIFIED
Carter, A.UNSPECIFIED
Jahagirdar, D.UNSPECIFIED
Biehl, M. H.UNSPECIFIED
Douwes-Schultz, D.UNSPECIFIED
Larson, S. L.UNSPECIFIED
Arora, M.UNSPECIFIED
Dwyer-Lindgren, L.UNSPECIFIED
Steuben, K. M.UNSPECIFIED
Abbastabar, H.UNSPECIFIED
Abu-Raddad, L. J.UNSPECIFIED
Abyu, D. M.UNSPECIFIED
Adabi, M.UNSPECIFIED
Adebayo, O. M.UNSPECIFIED
Adekanmbi, V.UNSPECIFIED
Adetokunboh, O. O.UNSPECIFIED
Ahmadi, A.UNSPECIFIED
Ahmadi, K.UNSPECIFIED
Ahmadian, E.UNSPECIFIED
Ahmadpour, E.UNSPECIFIED
Ahmed, M. B.UNSPECIFIED
Akal, C. G.UNSPECIFIED
Alahdab, F.UNSPECIFIED
Alam, N.UNSPECIFIED
Albertson, S. B.UNSPECIFIED
Alemnew, B. T. T.UNSPECIFIED
Alene, K. A.UNSPECIFIED
Alipour, V.UNSPECIFIED
Alvis-Guzman, N.UNSPECIFIED
Amini, S.UNSPECIFIED
Anbari, Z.UNSPECIFIED
Anber, N. H.UNSPECIFIED
Anjomshoa, M.UNSPECIFIED
Antonio, C. A. T.UNSPECIFIED
Arabloo, J.UNSPECIFIED
Aremu, O.UNSPECIFIED
Areri, H. A.UNSPECIFIED
Asfaw, E. T.UNSPECIFIED
Ashagre, A. F.UNSPECIFIED
Asmelash, D.UNSPECIFIED
Asrat, A. A.UNSPECIFIED
Avokpaho, EfgaUNSPECIFIED
Awasthi, A.UNSPECIFIED
Awoke, N.UNSPECIFIED
Ayanore, M. A.UNSPECIFIED
Azari, S.UNSPECIFIED
Badawi, A.UNSPECIFIED
Bagherzadeh, M.UNSPECIFIED
Banach, M.UNSPECIFIED
Barac, A.UNSPECIFIED
Barnighausen, T. W.UNSPECIFIED
Basu, S.UNSPECIFIED
Bedi, N.UNSPECIFIED
Behzadifar, M.UNSPECIFIED
Bekele, B. B.UNSPECIFIED
Belay, S. A.UNSPECIFIED
Belay, Y. B.UNSPECIFIED
Belayneh, Y. M. M.UNSPECIFIED
Berhane, A.UNSPECIFIED
Bhat, A. G.UNSPECIFIED
Bhattacharyya, K.UNSPECIFIED
Biadgo, B.UNSPECIFIED
Bijani, A.UNSPECIFIED
Bin Sayeed, M. S.UNSPECIFIED
Bitew, H.UNSPECIFIED
Blinov, A.UNSPECIFIED
Bogale, K. A.UNSPECIFIED
Bojia, H. A.UNSPECIFIED
Nagaraja, SbnbUNSPECIFIED
Butt, Z. A.UNSPECIFIED
Cahuana-Hurtado, L.UNSPECIFIED
Rincon, J. C. C.UNSPECIFIED
Carvalho, F.UNSPECIFIED
Chattu, V. K.UNSPECIFIED
Christopher, D. J.UNSPECIFIED
Chu, D. T.UNSPECIFIED
Crider, R.UNSPECIFIED
Dahiru, T.UNSPECIFIED
Dandona, L.UNSPECIFIED
Dandona, R.UNSPECIFIED
Daryani, A.UNSPECIFIED
das Neves, J.UNSPECIFIED
De Neve, J. W.UNSPECIFIED
Degenhardt, L.UNSPECIFIED
Demeke, F. M.UNSPECIFIED
Demis, A. B. B.UNSPECIFIED
Demissie, D. B.UNSPECIFIED
Demoz, G. T.UNSPECIFIED
Deribe, K.UNSPECIFIED
Des Jarlais, D.UNSPECIFIED
Dhungana, G. P.UNSPECIFIED
Diaz, D.UNSPECIFIED
Djalalinia, S.UNSPECIFIED
Do, H. P.UNSPECIFIED
Doan, L. P.UNSPECIFIED
Duber, H.UNSPECIFIED
Dubey, M.UNSPECIFIED
Dubljanin, E.UNSPECIFIED
Duken, E. E.UNSPECIFIED
Adema, B. D.UNSPECIFIED
othersUNSPECIFIED
Keywords: sex-specific mortality united-states life expectancy prevention challenges disability cities trends men Immunology Infectious Diseases
Divisions:
Page Range: E831-E859
Journal or Publication Title: Lancet Hiv
Journal Index: ISI
Volume: 6
Number: 12
Identification Number: https://doi.org/10.1016/s2352-3018(19)30196-1
ISSN: 2352-3018
Depositing User: مهندس مهدی شریفی
URI: http://eprints.medilam.ac.ir/id/eprint/2694

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