Journal article
Estimates of global, regional, and national incidence, prevalence, and mortality of HIV, 1980-2015: the Global Burden of Disease Study 2015
The lancet HIV, Vol.3(8), pp.E361-E387
08/01/2016
DOI: 10.1016/S2352-3018(16)30087-X
PMCID: PMC5056319
PMID: 27470028
Abstract
Background Timely assessment of the burden of HIV/AIDS is essential for policy setting and programme evaluation. In this report from the Global Burden of Disease Study 2015 (GBD 2015), we provide national estimates of levels and trends of HIV/AIDS incidence, prevalence, coverage of antiretroviral therapy (ART), and mortality for 195 countries and territories from 1980 to 2015.
Methods For countries without high-quality vital registration data, we estimated prevalence and incidence with data from antenatal care clinics and population-based seroprevalence surveys, and with assumptions by age and sex on initial CD4 distribution at infection, CD4 progression rates (probability of progression from higher to lower CD4 cell-count category), on and off antiretroviral therapy (ART) mortality, and mortality from all other causes. Our estimation strategy links the GBD 2015 assessment of all-cause mortality and estimation of incidence and prevalence so that for each draw from the uncertainty distribution all assumptions used in each step are internally consistent. We estimated incidence, prevalence, and death with GBD versions of the Estimation and Projection Package (EPP) and Spectrum software originally developed by the Joint United Nations Programme on HIV/AIDS (UNAIDS). We used an open-source version of EPP and recoded Spectrum for speed, and used updated assumptions from systematic reviews of the literature and GBD demographic data. For countries with high-quality vital registration data, we developed the cohort incidence bias adjustment model to estimate HIV incidence and prevalence largely from the number of deaths caused by HIV recorded in cause-of-death statistics. We corrected these statistics for garbage coding and HIV misclassification.
Findings Global HIV incidence reached its peak in 1997, at 3.3 million new infections (95% uncertainty interval [UI] 3.1-3.4 million). Annual incidence has stayed relatively constant at about 2.6 million per year (range 2.5-2.8 million) since 2005, after a period of fast decline between 1997 and 2005. The number of people living with HIV/AIDS has been steadily increasing and reached 38.8 million (95% UI 37.6-40.4 million) in 2015. At the same time, HIV/AIDS mortality has been declining at a steady pace, from a peak of 1.8 million deaths (95% UI 1.7-1.9 million) in 2005, to 1.2 million deaths (1.1-1.3 million) in 2015. We recorded substantial heterogeneity in the levels and trends of HIV/AIDS across countries. Although many countries have experienced decreases in HIV/AIDS mortality and in annual new infections, other countries have had slowdowns or increases in rates of change in annual new infections.
Interpretation Scale-up of ART and prevention of mother-to-child transmission has been one of the great successes of global health in the past two decades. However, in the past decade, progress in reducing new infections has been slow, development assistance for health devoted to HIV has stagnated, and resources for health in low-income countries have grown slowly. Achievement of the new ambitious goals for HIV enshrined in Sustainable Development Goal 3 and the 90-90-90 UNAIDS targets will be challenging, and will need continued efforts from governments and international agencies in the next 15 years to end AIDS by 2030. Copyright (C) The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license
Details
- Title: Subtitle
- Estimates of global, regional, and national incidence, prevalence, and mortality of HIV, 1980-2015: the Global Burden of Disease Study 2015
- Creators
- Haidong Wang - University of WashingtonTim M. Wolock - University of WashingtonAustin Carter - University of WashingtonGrant Nguyen - Institute for Health Metrics and EvaluationHmwe Hmwe Kyu - University of WashingtonEmmanuela Gakidou - University of WashingtonSimon I. Hay - Institute for Health Metrics and EvaluationEdward J. Mills - University of WashingtonAdam Trickey - Institute for Health Metrics and EvaluationWilliam Msemburi - Institute for Health Metrics and EvaluationMatthew M. Coates - Institute for Health Metrics and EvaluationMeghan D. Mooney - University of WashingtonMaya S. Fraser - University of WashingtonAmber Sligar - Institute for Health Metrics and EvaluationJoshua Salomon - Institute for Health Metrics and EvaluationHeidi J. Larson - Institute for Health Metrics and EvaluationJoseph Friedman - Institute for Health Metrics and EvaluationAmanuel Alemu Abajobir - Institute for Health Metrics and EvaluationKalkidan Hassen Abate - University of WashingtonKaja M. Abbas - Institute for Health Metrics and EvaluationMohamed Magdy Abd El Razek - Aswan UniversityFoad Abd-Allah - Institute for Health Metrics and EvaluationAbdishakur M. Abdulle - Institute for Health Metrics and EvaluationSemaw Ferede Abera - University of WashingtonIbrahim Abubakar - University of WashingtonLaith J. Abu-Raddad - Institute for Health Metrics and EvaluationNiveen M. E. Abu-Rmeileh - Birzeit UniversityGebre Yitayih Abyu - Mekelle UniversityAkindele Olupelumi Adebiyi - University of WashingtonIsaac Akinkunmi Adedeji - Institute for Health Metrics and EvaluationAdemola Lukman Adelekan - Institute for Health Metrics and EvaluationKoranteng Adofo - Kwame Nkrumah UniversityArsene Kouablan Adou - Institute for Health Metrics and EvaluationOluremi N. Ajala - Institute for Health Metrics and EvaluationTomi F. Akinyemiju - University of WashingtonNadia Akseer - Institute for Health Metrics and EvaluationFaris Hasan Al Lami - Baghdad Coll Med, Baghdad, IraqZiyad Al-Aly - Institute for Health Metrics and EvaluationKhurshid Alam - Institute for Health Metrics and EvaluationNoore K. M. Alam - The University of QueenslandDeena Alasfoor - Institute for Health Metrics and EvaluationSaleh Fahed S. Aldhahri - Institute for Health Metrics and EvaluationRobert William Aldridge - Institute for Health Metrics and EvaluationMiguel Angel Alegretti - Institute for Health Metrics and EvaluationAlicia V. Aleman - Institute for Health Metrics and EvaluationZewdie Aderaw Alemu - Institute for Health Metrics and EvaluationRafael Alfonso-Cristancho - University of WashingtonRaghib Ali - Institute for Health Metrics and EvaluationAla'a Alkerwi - Luxembourg Inst Hlth, Strassen, LuxembourgFrancois Alla - Institute for Health Metrics and EvaluationRajaa Mohammad Salem Al-Raddadi - Minist Hlth, Riyadh, Saudi ArabiaUbai Alsharif - Institute for Health Metrics and EvaluationElena Alvarez - Institute for Health Metrics and EvaluationNelson Alvis-Guzman - Institute for Health Metrics and EvaluationAzmeraw T. Amare - Institute for Health Metrics and EvaluationAlemayehu Amberbir - Institute for Health Metrics and EvaluationAdeladza Kofi Amegah - Institute for Health Metrics and EvaluationWalid Ammar - Institute for Health Metrics and EvaluationStephen Marc Amrock - Institute for Health Metrics and EvaluationCarl Abelardo T. Antonio - Institute for Health Metrics and EvaluationPalwasha Anwari - Institute for Health Metrics and EvaluationJohan Arnlov - Institute for Health Metrics and EvaluationAl Artaman - Institute for Health Metrics and EvaluationHamid Asayesh - Institute for Health Metrics and EvaluationRana Jawad Asghar - Institute for Health Metrics and EvaluationReza Assadi - Institute for Health Metrics and EvaluationSuleman Atique - Institute for Health Metrics and EvaluationLydia S. Atkins - Institute for Health Metrics and EvaluationEuripide Frinel G. Arthur Avokpaho - Africare Benin, Cotonou, BeninAshish Awasthi - Institute for Health Metrics and EvaluationBeatriz Paulina Ayala Quintanilla - Institute for Health Metrics and EvaluationUmar Bacha - Institute for Health Metrics and EvaluationAlaa Badawi - Institute for Health Metrics and EvaluationAleksandra Barac - Institute for Health Metrics and EvaluationTill Barnighausen - Harvard UniversityArindam Basu - Institute for Health Metrics and EvaluationTigist Assefa Bayou - Institute for Health Metrics and EvaluationYibeltal Tebekaw Bayou - Institute for Health Metrics and EvaluationShahrzad Bazargan-Hejazi - University of WashingtonJustin Beardsley - Institute for Health Metrics and EvaluationNeeraj Bedi - Institute for Health Metrics and EvaluationDerrick A. Bennett - Institute for Health Metrics and EvaluationIsabela M. Bensenor - Institute for Health Metrics and EvaluationBalem Demtsu Betsu - Institute for Health Metrics and EvaluationAddisu Shunu Beyene - Haramaya UniversityEesh Bhatia - Institute for Health Metrics and EvaluationZulfiqar A. Bhutta - Institute for Health Metrics and EvaluationSibhatu Biadgilign - Institute for Health Metrics and EvaluationBoris Bikbov - Institute for Health Metrics and EvaluationSait Mentes Birlik - Institute for Health Metrics and EvaluationDonal Bisanzio - University of WashingtonMichael Brainin - Institute for Health Metrics and EvaluationAlexandra Brazinova - Institute for Health Metrics and EvaluationNicholas J. K. Breitborde - Institute for Health Metrics and EvaluationAlexandria Brown - Institute for Health Metrics and EvaluationMichael Burch - Institute for Health Metrics and EvaluationZahid A. Butt - Institute for Health Metrics and EvaluationJulio Cesar Campuzano - Institute for Health Metrics and EvaluationRosario Cardenas - Institute for Health Metrics and EvaluationJuan Jesus Carrero - Institute for Health Metrics and EvaluationGBD 2015 HIV CollaboratorsDavid C Schwebel (Contributor)
- Resource Type
- Journal article
- Publication Details
- The lancet HIV, Vol.3(8), pp.E361-E387
- DOI
- 10.1016/S2352-3018(16)30087-X
- PMID
- 27470028
- PMCID
- PMC5056319
- NLM abbreviation
- Lancet HIV
- ISSN
- 2352-3018
- eISSN
- 2352-3018
- Publisher
- Elsevier
- Number of pages
- 27
- Grant note
- P300P3-154634 / Swiss National Science Foundation (SNSF) WHO; World Health Organization O1ER1511D / German National Cohort Consortium Wellcome Trust-DBT India Alliance Clinical and Public Health Intermediate Fellowship; Wellcome Trust Fonds de la recherche en sante du Quebec (FRSQ); Fonds de recherche du Quebec (FRQ); Fonds de recherche du Quebec - Sante (FRQS) Swedish Research Council International Society of Nephrology (ISN) Academy of Finland; Research Council of Finland NIHR Oxford Biomedical Research Centre; National Institutes of Health Research (NIHR) Alzheimer's Research AMP; Prevention Foundation
- Language
- English
- Date published
- 08/01/2016
- Academic Unit
- Research Administration
- Record Identifier
- 9984949464002771
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