Mapping age- and sex-specific HIV prevalence in adults in sub-Saharan Africa, 2000-2018
;
Savita Lasrado;
Paul H Lee;
Shanshan Li;
Xuefeng Liu;
Afshin Maleki;
Preeti Malik;
Mohammad Ali Mansournia;
Francisco Rogerlândio Martins-Melo;
Walter Mendoza;
Ritesh G Menezes;
Endalkachew Worku Mengesha;
Tuomo J Meretoja;
Tomislav Mestrovic;
Andreea Mirica;
Babak Moazen;
Osama Mohamad;
Yousef Mohammad;
Abdollah Mohammadian-Hafshejani;
Reza Mohammadpourhodki;
Salahuddin Mohammed;
Shafiu Mohammed;
Ali H Mokdad;
Masoud Moradi;
Paula Moraga;
Sumaira Mubarik;
Getaneh Baye B Mulu;
Lillian Mwanri;
Ahamarshan Jayaraman Nagarajan;
Mukhammad David Naimzada;
Muhammad Naveed;
Javad Nazari;
Rawlance Ndejjo;
Ionut Negoi;
Frida N Ngalesoni;
Georges Nguefack-Tsague;
Josephine W Ngunjiri;
Cuong Tat Nguyen;
Huong Lan Thi Nguyen;
Chukwudi A Nnaji;
Jean Jacques Noubiap;
Virginia Nuñez-Samudio;
Vincent Ebuka Nwatah;
Bogdan Oancea;
Oluwakemi Ololade Odukoya;
Andrew T Olagunju;
Babayemi Oluwaseun Olakunde;
Bolajoko Olubukunola Olusanya;
Jacob Olusegun Olusanya;
Ahmed Omar Bali;
Obinna E Onwujekwe;
Orish Ebere Orisakwe;
Nikita Otstavnov;
Stanislav S Otstavnov;
Mayowa O Owolabi;
PA Mahesh;
Jagadish Rao Padubidri;
Adrian Pana;
Ashok Pandey;
Seithikurippu R Pandi-Perumal;
Fatemeh Pashazadeh Kan;
George C Patton;
Shrikant Pawar;
Emmanuel K Peprah;
Maarten J Postma;
Liliana Preotescu;
Zahiruddin Quazi Syed;
Navid Rabiee;
Amir Radfar;
Alireza Rafiei;
Fakher Rahim;
Vafa Rahimi-Movaghar;
Amir Masoud Rahmani;
Kiana Ramezanzadeh;
Juwel Rana;
Chhabi Lal Ranabhat;
Sowmya J Rao;
David Laith Rawaf;
Salman Rawaf;
Reza Rawassizadeh;
Lemma Demissie Regassa ;
Nima Rezaei;
Aziz Rezapour;
Mavra A Riaz;
Ana Isabel Ribeiro;
Jennifer M Ross;
Enrico Rubagotti;
Susan Fred Rumisha;
Godfrey M Rwegerera;
Sahar Saeedi Moghaddam;
Rajesh Sagar;
Biniyam Sahiledengle;
Maitreyi Sahu;
Marwa Rashad Salem;
Hossein Samadi Kafil;
Abdallah M Samy;
Benn Sartorius;
Brijesh Sathian;
Abdul-Aziz Seidu;
Amira A Shaheen;
Masood Ali Shaikh;
Morteza Shamsizadeh;
Wondimeneh Shibabaw Shiferaw;
Jae Il Shin;
Roman Shrestha;
Jasvinder A Singh;
Valentin Yurievich Skryabin;
Anna Aleksandrovna Skryabina;
Shahin Soltani;
Mu'awiyyah Babale Sufiyan;
Takahiro Tabuchi;
Eyayou Girma Tadesse;
Nuno Taveira;
Fisaha Haile Tesfay;
Rekha Thapar;
Marcos Roberto Tovani-Palone;
Gebiyaw Wudie Tsegaye;
Chukwuma David Umeokonkwo;
Bhaskaran Unnikrishnan;
Jorge Hugo Villafañe;
Francesco S Violante;
Bay Vo;
Giang Thu Vu;
Yohannes Dibaba Wado;
Yasir Waheed;
Richard G Wamai;
Yanzhong Wang;
Paul Ward;
Nuwan Darshana Wickramasinghe;
Katherine Wilson;
Sanni Yaya;
Paul Yip;
Naohiro Yonemoto;
Chuanhua Yu;
Mikhail Sergeevich Zastrozhin;
Yunquan Zhang;
Zhi-Jiang Zhang;
Simon I Hay;
Laura Dwyer-Lindgren;
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: 10.1186/s12916-022-02639-z
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.
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