Defining control of HIV epidemics. Issue 11 (November 2018)

• Record Type: Journal Article
• Authors: Galvani, Alison P; Pandey, Abhishek; Fitzpatrick, Meagan C; Medlock, Jan; Gray, Glenda E
• Is Part Of: Lancet. Volume 5:Issue 11(2018)
• Page Start: e667
• Page End: e670
• Publication Date: 2018-11
• Subjects: HIV (Viruses) -- Periodicals; HIV infections -- Periodicals; AIDS (Disease) -- Periodicals; 616.9792
• DOI: 10.1016/S2352-3018(18)30178-4
• Languages: English
• ISSNs: 2405-4704

Abstract

Summary: Although the HIV pandemic remains a global crisis, much progress has been made in implementing programmes to treat and prevent HIV infection. To guide prioritisation of efforts, the metric by which a country can declare its HIV epidemic as controlled has become increasingly relevant. Herein, we evaluate the merits of the four control criteria proposed by UNAIDS: percentage reduction in incidence over time; ratio of incidence to mortality; ratio of incidence to prevalence; and annual incidence. Using a transmission model to generate projections of demography, incidence, and mortality, we highlight potential pitfalls associated with each of the first three criteria. A definition of control based on annual incidence would provide clarity and consistency across settings.