Mapping age- and sex-specific HIV prevalence in adults in sub-Saharan Africa, 2000-2018

Haeuser, Emily; Serfes, Audrey L; Cork, Michael A; Yang, Mingyou; Abbastabar, Hedayat; Abhilash, ES; Adabi, Maryam; Adebayo, Oladimeji M; Adekanmbi, Victor; Adeyinka, Daniel Adedayo; +298 more... Afzal, Saira; Ahinkorah, Bright Opoku; Ahmadi, Keivan; Ahmed, Muktar Beshir; Akalu, Yonas; Akinyemi, Rufus Olusola; Akunna, Chisom Joyqueenet; Alahdab, Fares; Alanezi, Fahad Mashhour; Alanzi, Turki M; Alene, Kefyalew Addis; Alhassan, Robert Kaba; Alipour, Vahid; Almasi-Hashiani, Amir; Alvis-Guzman, Nelson; Ameyaw, Edward Kwabena; Amini, Saeed; Amugsi, Dickson A; Ancuceanu, Robert; Anvari, Davood; Appiah, Seth Christopher Yaw; Arabloo, Jalal; Aremu, Olatunde; Asemahagn, Mulusew A; Jafarabadi, Mohammad Asghari; Awedew, Atalel Fentahun; Quintanilla, Beatriz Paulina Ayala; Ayanore, Martin Amogre; Aynalem, Yared Asmare; Azari, Samad; Azene, Zelalem Nigussie; Darshan, BB; Babalola, Tesleem Kayode; Baig, Atif Amin; Banach, Maciej; Bärnighausen, Till Winfried; Bell, Arielle Wilder; Bhagavathula, Akshaya Srikanth; Bhardwaj, Nikha; Bhardwaj, Pankaj; Bhattacharyya, Krittika; Bijani, Ali; Bitew, Zebenay Workneh; Bohlouli, Somayeh; Bolarinwa, Obasanjo Afolabi; Boloor, Archith; Bozicevic, Ivana; Butt, Zahid A; Cárdenas, Rosario; Carvalho, Felix; Charan, Jaykaran; Chattu, Vijay Kumar; Chowdhury, Mohiuddin Ahsanul Kabir; Chu, Dinh-Toi; Cowden, Richard G; Dahlawi, Saad MA; Damiani, Giovanni; Darteh, Eugene Kofuor Maafo; Darwesh, Aso Mohammad; das Neves, José; Weaver, Nicole Davis; De Leo, Diego; De Neve, Jan-Walter; Deribe, Kebede; Deuba, Keshab; Dharmaratne, Samath; Dianatinasab, Mostafa; Diaz, Daniel; Didarloo, Alireza; Djalalinia, Shirin; Dorostkar, Fariba; Dubljanin, Eleonora; Duko, Bereket; El Tantawi, Maha; El-Jaafary, Shaimaa I; Eshrati, Babak; Eskandarieh, Sharareh; Eyawo, Oghenowede; Ezeonwumelu, Ifeanyi Jude; Ezzikouri, Sayeh; Farzadfar, Farshad; Fattahi, Nazir; Fauk, Nelsensius Klau; Fernandes, Eduarda; Filip, Irina; Fischer, Florian; Foigt, Nataliya A; Foroutan, Masoud; Fukumoto, Takeshi; Gad, Mohamed M; Gaidhane, Abhay Motiramji; Gebregiorgis, Birhan Gebresillassie; Gebremedhin, Ketema Bizuwork; Getacher, Lemma; Ghadiri, Keyghobad; Ghashghaee, Ahmad; Golechha, Mahaveer; Gubari, Mohammed Ibrahim Mohialdeen; Gugnani, Harish Chander; Guimarães, Rafael Alves; Haider, Mohammad Rifat; Haj-Mirzaian, Arvin; Hamidi, Samer; Hashi, Abdiwahab; Hassanipour, Soheil; Hassankhani, Hadi; Hayat, Khezar; Herteliu, Claudiu; Ho, Hung Chak; Holla, Ramesh; Hosseini, Mostafa; Hosseinzadeh, Mehdi; Hwang, Bing-Fang; Ibitoye, Segun Emmanuel; Ilesanmi, Olayinka Stephen; Ilic, Irena M; Ilic, Milena D; Islam, Rakibul M; Iwu, Chidozie CD; Jakovljevic, Mihajlo; Jha, Ravi Prakash; Ji, John S; Johnson, Kimberly B; Joseph, Nitin; Joshua, Vasna; Joukar, Farahnaz; Jozwiak, Jacek Jerzy; Kalankesh, Leila R; Kalhor, Rohollah; Kamyari, Naser; Kanchan, Tanuj; Matin, Behzad Karami; Karimi, Salah Eddin; Kayode, Gbenga A; Karyani, Ali Kazemi; Keramati, Maryam; Khan, Ejaz Ahmad; Khan, Gulfaraz; Khan, Md Nuruzzaman; Khatab, Khaled; Khubchandani, Jagdish; Kim, Yun Jin; Kisa, Adnan; Kisa, Sezer; Kopec, Jacek A; Kosen, Soewarta; Laxminarayana, Sindhura Lakshmi Koulmane; Koyanagi, Ai; Krishan, Kewal; Defo, Barthelemy Kuate; Kugbey, Nuworza; Kulkarni, Vaman; Kumar, Manasi; Kumar, Nithin; Kusuma, Dian; La Vecchia, Carlo; Lal, Dharmesh Kumar; Landires, Iván; Larson, Heidi Jane; Lasrado, Savita; Lee, Paul H; Li, Shanshan; Liu, Xuefeng; Maleki, Afshin; Malik, Preeti; Mansournia, Mohammad Ali; Martins-Melo, Francisco Rogerlândio; Mendoza, Walter; Menezes, Ritesh G; Mengesha, Endalkachew Worku; Meretoja, Tuomo J; Mestrovic, Tomislav; Mirica, Andreea; Moazen, Babak; Mohamad, Osama; Mohammad, Yousef; Mohammadian-Hafshejani, Abdollah; Mohammadpourhodki, Reza; Mohammed, Salahuddin; Mohammed, Shafiu; Mokdad, Ali H; Moradi, Masoud; Moraga, Paula; Mubarik, Sumaira; Mulu, Getaneh Baye B; Mwanri, Lillian; Nagarajan, Ahamarshan Jayaraman; Naimzada, Mukhammad David; Naveed, Muhammad; Nazari, Javad; Ndejjo, Rawlance; Negoi, Ionut; Ngalesoni, Frida N; Nguefack-Tsague, Georges; Ngunjiri, Josephine W; Nguyen, Cuong Tat; Nguyen, Huong Lan Thi; Nnaji, Chukwudi A; Noubiap, Jean Jacques; Nuñez-Samudio, Virginia; Nwatah, Vincent Ebuka; Oancea, Bogdan; Odukoya, Oluwakemi Ololade; Olagunju, Andrew T; Olakunde, Babayemi Oluwaseun; Olusanya, Bolajoko Olubukunola; Olusanya, Jacob Olusegun; Bali, Ahmed Omar; Onwujekwe, Obinna E; Orisakwe, Orish Ebere; Otstavnov, Nikita; Otstavnov, Stanislav S; Owolabi, Mayowa O; Mahesh, PA; Padubidri, Jagadish Rao; Pana, Adrian; Pandey, Ashok; Pandi-Perumal, Seithikurippu R; Kan, Fatemeh Pashazadeh; Patton, George C; Pawar, Shrikant; Peprah, Emmanuel K; Postma, Maarten J; Preotescu, Liliana; Syed, Zahiruddin Quazi; Rabiee, Navid; Radfar, Amir; Rafiei, Alireza; Rahim, Fakher; Rahimi-Movaghar, Vafa; Rahmani, Amir Masoud; Ramezanzadeh, Kiana; Rana, Juwel; Ranabhat, Chhabi Lal; Rao, Sowmya J; Rawaf, David Laith; Rawaf, Salman; Rawassizadeh, Reza; Regassa, Lemma Demissie; Rezaei, Nima; Rezapour, Aziz; Riaz, Mavra A; Ribeiro, Ana Isabel; Ross, Jennifer M; Rubagotti, Enrico; Rumisha, Susan Fred; Rwegerera, Godfrey M; Moghaddam, Sahar Saeedi; Sagar, Rajesh; Sahiledengle, Biniyam; Sahu, Maitreyi; Salem, Marwa Rashad; Kafil, Hossein Samadi; Samy, Abdallah M; Sartorius, Benn; Sathian, Brijesh; Seidu, Abdul-Aziz; Shaheen, Amira A; Shaikh, Masood Ali; Shamsizadeh, Morteza; Shiferaw, Wondimeneh Shibabaw; Shin, Jae Il; Shrestha, Roman; Singh, Jasvinder A; Skryabin, Valentin Yurievich; Skryabina, Anna Aleksandrovna; Soltani, Shahin; Sufiyan, Mu'awiyyah Babale; Tabuchi, Takahiro; Tadesse, Eyayou Girma; Taveira, Nuno; Tesfay, Fisaha Haile; Thapar, Rekha; Tovani-Palone, Marcos Roberto; Tsegaye, Gebiyaw Wudie; Umeokonkwo, Chukwuma David; Unnikrishnan, Bhaskaran; Villafañe, Jorge Hugo; Violante, Francesco S; Vo, Bay; Vu, Giang Thu; Wado, Yohannes Dibaba; Waheed, Yasir; Wamai, Richard G; Wang, Yanzhong; Ward, Paul; Wickramasinghe, Nuwan Darshana; Wilson, Katherine; Yaya, Sanni; Yip, Paul; Yonemoto, Naohiro; Yu, Chuanhua; Zastrozhin, Mikhail Sergeevich; Zhang, Yunquan; Zhang, Zhi-Jiang; Hay, Simon I; Dwyer-Lindgren, Laura; Local Burden of Disease sub-Saharan Africa HIV Prevalence Collab; (2022) Mapping age- and sex-specific HIV prevalence in adults in sub-Saharan Africa, 2000-2018. BMC medicine, 20 (1). p. 488. ISSN 1741-7015 DOI: https://doi.org/10.1186/s12916-022-02639-z

Abstract

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.

Additional Information

Item Type	Article
Faculty and Department	Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology (-2023)
PubMed ID	36529768
Elements ID	197396
Official URL	http://dx.doi.org/10.1186/s12916-022-02639-z