HIV incidence and prevalence among adults aged 15-64 years in Rwanda: Results from the Rwanda Population-based HIV Impact Assessment (RPHIA) and District-level Modeling, 2019. (March 2022)

• Record Type: Journal Article
• Authors: Nsanzimana, Sabin; Rwibasira, Gallican Nshogoza; Malamba, Samuel Sewava; Musengimana, Gentille; Kayirangwa, Eugenie; Jonnalagadda, Sasi; Fazito Rezende, Erika; Eaton, Jeffrey W; Mugisha, Veronicah; Remera, Eric; Muhamed, Semakula; Mulindabigwi, Augustin; Omolo, Jared; Weisner, Lubbe; Moore, Carole; Patel, Hetal; Justman, Jessica E
• Is Part Of: International journal of infectious diseases. Volume 116(2022)
• Page Start: 245
• Page End: 254
• Publication Date: 2022-03
• Subjects: HIV -- Rwanda -- Prevalence -- Incidence -- population-based surveys -- Naomi model; Communicable diseases -- Periodicals; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; Electronic journals; 616.9
• DOI: 10.1016/j.ijid.2022.01.032
• Languages: English
• ISSNs: 1201-9712

Abstract

Highlights: · HIV incidence of 0.08% among adults, indicates a successful national HIV program · Rwanda has a stable HIV Epidemic at 3% and an aging cohort of people living with HIV · District-level modeling has helped identify areas disproportionately affected Abstract: Objectives: The 2018–2019 Rwanda Population–based HIV Impact Assessment (RPHIA) was conducted to measure national HIV incidence and prevalence. District-level estimates were modeled to inform resources allocation. Methods: RPHIA was a nationally representative cross-sectional household survey. Consenting adults were interviewed and tested for HIV using the national diagnostic algorithm followed by laboratory-based confirmation of HIV status and testing for viral load (VL), limiting antigen (LAg) avidity, and presence of antiretrovirals. Incidence was calculated using normalized optical density ≤ 1·5, VL ≥ 1, 000 copies/mL, and undetectable antiretrovirals. Survey and programmatic data were used to model district-level HIV incidence and prevalence. Results: Of 31, 028 eligible adults, 98·7% participated in RPHIA and 934 tested HIV positive. HIV prevalence among adults in Rwanda was 3·0% (95% CI:2·7–3·3). National HIV incidence was 0·08% (95% CI:0·02–0·14) and 0·11% (95% CI:0·00–0·26) in the City of Kigali (CoK). Based on district-level modeling, HIV incidence was greatest in the 3 CoK districts (0·11% to 0·15%) and varied across other districts (0·03% to 0·10%). Conclusions: HIV prevalence among adults in Rwanda is 3.0%; HIV incidence is low at 0.08%. District-level modeling has identified disproportionately affected urban hotspots: areas to focus resources.