Global, regional, and national sex-specific burden and control of the HIV epidemic, 1990–2019, for 204 countries and territories: the Global Burden of Diseases Study 2019. Issue 10 (October 2021)

• Record Type: Journal Article
• Authors: Jahagirdar, Deepa; Walters, Magdalene K; Novotney, Amanda; Brewer, Edmond D; Frank, Tahvi D; Carter, Austin; Biehl, Molly H; Abbastabar, Hedayat; Abhilash, E S; Abu-Gharbieh, Eman; Abu-Raddad, Laith Jamal; Adekanmbi, Victor; Adeyinka, Daniel Adedayo; Adnani, Qorinah Estiningtyas Sakilah; Afzal, Saira; Aghababaei, Soodabeh; Ahinkorah, Bright Opoku; Ahmad, Sajjad; Ahmadi, Keivan; Ahmadi, Sepideh; Ahmadpour, Ehsan; Ahmed, Muktar Beshir; Ahmed Rashid, Tarik; Ahmed Salih, Yusra; Aklilu, Addis; Akram, Tayyaba; Akunna, Chisom Joyqueenet; Al Hamad, Hanadi; Alahdab, Fares; Alanezi, Fahad Mashhour; Aleksandrova, Ekaterina A; Alene, Kefyalew Addis; Ali, Liaqat; Alipour, Vahid; Almustanyir, Sami; Alvis-Guzman, Nelson; Ameyaw, Edward Kwabena; Amu, Hubert; Andrei, Catalina Liliana; Andrei, Tudorel; Anvari, Davood; Arabloo, Jalal; Aremu, Olatunde; Arulappan, Judie; Atnafu, Desta Debalkie; Ayala Quintanilla, Beatriz Paulina; Ayza, Muluken Altaye; Azari, Samad; B, Darshan B; Banach, Maciej; Bärnighausen, Till Winfried; Barra, Fabio; Barrow, Amadou; Basu, Sanjay; Bazargan-Hejazi, Shahrzad; Belay, Habtamu Gebrehana; Berheto, Tezera Moshago; Bezabhe, Woldesellassie Mequanint; Bezabih, Yihienew Mequanint; Bhagavathula, Akshaya Srikanth; Bhardwaj, Nikha; Bhardwaj, Pankaj; Bhattacharyya, Krittika; Bibi, Sadia; Bijani, Ali; Bisignano, Catherine; Bolarinwa, Obasanjo Afolabi; Boloor, Archith; Boltaev, Azizbek A; Briko, Nikolay Ivanovich; Buonsenso, Danilo; Burkart, Katrin; Butt, Zahid A; Cao, Chao; Charan, Jaykaran; Chatterjee, Souranshu; Chattu, Soosanna Kumary; Chattu, Vijay Kumar; Choudhari, Sonali Gajanan; Chu, Dinh-Toi; Couto, Rosa A S; Cowden, Richard G; Dachew, Berihun Assefa; Dadras, Omid; Dagnew, Amare Belachew; Dahlawi, Saad M A; Dai, Xiaochen; Dandona, Lalit; Dandona, Rakhi; das Neves, José; Degenhardt, Louisa; Demeke, Feleke Mekonnen; Desta, Abebaw Alemayehu; Deuba, Keshab; Dhamnetiya, Deepak; Dhungana, Govinda Prasad; Dianatinasab, Mostafa; Diaz, Daniel; Djalalinia, Shirin; Doan, Linh Phuong; Dorostkar, Fariba; Edinur, Hisham Atan; Effiong, Andem; Eftekharzadeh, Sahar; El Sayed Zaki, Maysaa; Elayedath, Rajesh; Elhadi, Muhammed; El-Jaafary, Shaimaa I; El-Khatib, Ziad; Elsharkawy, Aisha; Endalamaw, Aklilu; Endries, Aman Yesuf; Eskandarieh, Sharareh; Ezeonwumelu, Ifeanyi Jude; Ezzikouri, Sayeh; Farahmand, Mohammad; Faraon, Emerito Jose A; Fasanmi, Abidemi Omolara; Ferrero, Simone; Ferro Desideri, Lorenzo; Filip, Irina; Fischer, Florian; Folayan, Morenike Oluwatoyin; Foroutan, Masoud; Fukumoto, Takeshi; Gad, Mohamed M; Gadanya, Muktar A; Gaidhane, Abhay Motiramji; Garg, Tushar; Gayesa, Reta Tsegaye; Gebreyohannes, Eyob Alemayehu; Gesesew, Hailay Abrha; Getachew Obsa, Abera; Ghadiri, Keyghobad; Ghashghaee, Ahmad; Gilani, Syed Amir; Ginindza, Themba G; Glavan, Ionela-Roxana; Glushkova, Ekaterina Vladimirovna; Golechha, Mahaveer; Gugnani, Harish Chander; Gupta, Bhawna; Gupta, Sapna; Gupta, Veer Bala; Gupta, Vivek Kumar; Hamidi, Samer; Handanagic, Senad; Haque, Shafiul; Harapan, Harapan; Hargono, Arief; Hasaballah, Ahmed I; Hashi, Abdiwahab; Hassan, Shoaib; Hassanipour, Soheil; Hayat, Khezar; Heredia-Pi, Ileana; Hezam, Kamal; Holla, Ramesh; Hoogar, Praveen; Hoque, Mohammad Enamul; Hosseini, Mostafa; Hosseinzadeh, Mehdi; Hsairi, Mohamed; Hussain, Rabia; Ibitoye, Segun Emmanuel; Idrisov, Bulat; Ikuta, Kevin S; Ilesanmi, Olayinka Stephen; Ilic, Irena M; Ilic, Milena D; Irvani, Seyed Sina Naghibi; Islam, M Mofizul; Ismail, Nahlah Elkudssiah; Itumalla, Ramaiah; Iyamu, Ihoghosa Osamuyi; Jabbarinejad, Roxana; Jain, Vardhmaan; Jayawardena, Ranil; Jha, Ravi Prakash; Joseph, Nitin; Kabir, Ali; Kabir, Zubair; Kalhor, Rohollah; Kaliyadan, Feroze; Kamath, Ashwin; Kanchan, Tanuj; Kandel, Himal; Kassahun, Getinet; Katoto, Patrick DMC; Kayode, Gbenga A; Kebede, Ermiyas Mulu; Kebede, Hafte Kahsay; Khajuria, Himanshu; Khalid, Nauman; Khan, Ejaz Ahmad; Khan, Gulfaraz; Khatab, Khaled; Kim, Min Seo; Kim, Yun Jin; Kisa, Adnan; Kisa, Sezer; Kochhar, Sonali; Korshunov, Vladimir Andreevich; Koul, Parvaiz A; Koulmane Laxminarayana, Sindhura Lakshmi; Koyanagi, Ai; Krishan, Kewal; Kuate Defo, Barthelemy; Kumar, G Anil; Kumar, Manasi; Kumar, Nithin; Kwarteng, Alexander; Lal, Dharmesh Kumar; Landires, Iván; Lasrado, Savita; Lassi, Zohra S; Lazarus, Jeffrey V; Lee, Jane Jean-Hee; Lee, Yeong Yeh; LeGrand, Kate E; Lin, Christine; Liu, Xuefeng; Maddison, Emilie R; Magdy Abd El Razek, Hassan; Mahasha, Phetole Walter; Majeed, Azeem; Makki, Alaa; Malik, Ahmad Azam; Manamo, Wondimu Ayele; Mansournia, Mohammad Ali; Martins-Melo, Francisco Rogerlândio; Masoumi, Seyedeh Zahra; Memish, Ziad A; Menezes, Ritesh G; Mengesha, Endalkachew Worku; Merie, Hayimro Edemealem; Mersha, Amanual Getnet; Mestrovic, Tomislav; Meylakhs, Peter; Mheidly, Nour; Miller, Ted R; Mirica, Andreea; Moazen, Babak; Mohammad, Yousef; Mohammadi, Mokhtar; Mohammed, Arif; Mohammed, Salahuddin; Mohammed, Shafiu; Moitra, Modhurima; Mokdad, Ali H; Molokhia, Mariam; Moni, Mohammad Ali; Moradi, Ghobad; Moradi, Yousef; Mpundu-Kaambwa, Christine; Mubarik, Sumaira; Munro, Sandra B; Mwanri, Lillian; Nachega, Jean B; Nagarajan, Ahamarshan Jayaraman; Narayana, Aparna Ichalangod; Naveed, Muhammad; Nayak, Biswa Prakash; Nduaguba, Sabina O; Neupane Kandel, Sandhya; Nguefack-Tsague, Georges; Nguyen, Trang Huyen; Nixon, Molly R; Nnaji, Chukwudi A; Noubiap, Jean Jacques; Nuñez-Samudio, Virginia; Nyirenda, Thomas Elliot; Oghenetega, Onome Bright; Olagunju, Andrew T; Olakunde, Babayemi Oluwaseun; Owopetu, Oluwatomi Funbi; P A, Mahesh; Padubidri, Jagadish Rao; Pakhale, Smita; Parekh, Tarang; Pashazadeh Kan, Fatemeh; Pawar, Shrikant; Pepito, Veincent Christian Filipino; Peprah, Emmanuel K; Pinheiro, Marina; Pokhrel, Khem Narayan; Polibin, Roman V; Pollok, Richard Charles G; Postma, Maarten J; Quazi Syed, Zahiruddin; Radfar, Amir; Radhakrishnan, Raghu Anekal; Rahim, Fakher; Rahimi-Movaghar, Vafa; Rahimzadeh, Shadi; Rahman, Mosiur; Rahmani, Amir Masoud; Ram, Pradhum; Ranabhat, Chhabi Lal; Ranasinghe, Priyanga; Rao, Chythra R; Rao, Sowmya J; Rathi, Priya; Rawaf, David Laith; Rawaf, Salman; Regassa, Lemma Demissie; Rehman, Inayat ur; Renzaho, Andre M N; Rezaei, Nima; Rezahosseini, Omid; Rezai, Mohammad sadegh; Rezapour, Aziz; Ripon, Rezaul Karim; Rodrigues, Voilet; Roshchin, Denis O; Rwegerera, Godfrey M; Saeed, Umar; Saeedi Moghaddam, Sahar; Sagar, Rajesh; Saif-Ur-Rahman, KM; Salem, Marwa Rashad; Samaei, Mehrnoosh; Samy, Abdallah M; Santric-Milicevic, Milena M; Saroshe, Satish; Sathian, Brijesh; Satpathy, Maheswar; Sawhney, Monika; Schutte, Aletta Elisabeth; Seylani, Allen; Shaikh, Masood Ali; Shaka, Mohammed Feyisso; Shamshad, Hina; Shamsizadeh, Morteza; Shannawaz, Mohammed; Shetty, Adithi; Shin, Jae Il; Shivakumar, K M; Singh, Jasvinder A; Skryabin, Valentin Yurievich; Skryabina, Anna Aleksandrovna; Somayaji, Ranjani; Soshnikov, Sergey; Spurlock, Emma Elizabeth; Stein, Dan J; Sufiyan, Mu'awiyyah Babale; Tadbiri, Hooman; Tadesse, Birkneh Tilahun; Tadesse, Eyayou Girma; Tamiru, Animut Tagele; Tarkang, Elvis Enowbeyang; Taveira, Nuno; Tekalegn, Yohannes; Tesfay, Fisaha Haile; Tessema, Gizachew Assefa; Thapar, Rekha; Tovani-Palone, Marcos Roberto; Traini, Eugenio; Tran, Bach Xuan; Tsai, Alexander C; Tusa, Biruk Shalmeno; Ullah, Saif; Umeokonkwo, Chukwuma David; Unnikrishnan, Bhaskaran; Valadan Tahbaz, Sahel; Villafañe, Jorge Hugo; Vladimirov, Sergey Konstantinovitch; Vo, Bay; Vongpradith, Avina; Vu, Giang Thu; Waheed, Yasir; Wamai, Richard G; Wang, Guan; Wang, Yanzhong; Ward, Paul; Westerman, Ronny; Winkler, Andrea Sylvia; Yadav, Lalit; Yahyazadeh Jabbari, Seyed Hossein; Yazie, Taklo Simeneh; Yi, Siyan; Yigit, Vahit; Yirdaw, Birhanu Wubale; Yonemoto, Naohiro; Yu, Chuanhua; Yunusa, Ismaeel; Zastrozhin, Mikhail Sergeevich; Zastrozhina, Anasthasia; Zhang, Zhi-Jiang; Zumla, Alimuddin; Salomon, Joshua A; Eaton, Jeffrey W; Naghavi, Mohsen; Dwyer-Lindgren, Laura; Wang, Haidong; Lim, Stephen S; Hay, Simon I; Murray, Christopher J L; Kyu, Hmwe Hmwe;
• Is Part Of: Lancet. Volume 8:Issue 10(2021)
• Page Start: e633
• Page End: e651
• Publication Date: 2021-10
• Subjects: HIV (Viruses) -- Periodicals; HIV infections -- Periodicals; AIDS (Disease) -- Periodicals; 616.9792
• DOI: 10.1016/S2352-3018(21)00152-1
• Languages: English
• ISSNs: 2405-4704

Abstract

Summary: Background: The sustainable development goals (SDGs) aim to end HIV/AIDS as a public health threat by 2030. Understanding the current state of the HIV epidemic and its change over time is essential to this effort. This study assesses the current sex-specific HIV burden in 204 countries and territories and measures progress in the control of the epidemic. Methods: To estimate age-specific and sex-specific trends in 48 of 204 countries, we extended the Estimation and Projection Package Age-Sex Model to also implement the spectrum paediatric model. We used this model in cases where age and sex specific HIV-seroprevalence surveys and antenatal care-clinic sentinel surveillance data were available. For the remaining 156 of 204 locations, we developed a cohort-incidence bias adjustment to derive incidence as a function of cause-of-death data from vital registration systems. The incidence was input to a custom Spectrum model. To assess progress, we measured the percentage change in incident cases and deaths between 2010 and 2019 (threshold >75% decline), the ratio of incident cases to number of people living with HIV (incidence-to-prevalence ratio threshold <0·03), and the ratio of incident cases to deaths (incidence-to-mortality ratio threshold <1·0). Findings: In 2019, there were 36·8 million (95% uncertainty interval [UI] 35·1–38·9) people living with HIV worldwide. There were 0·84 males (95% UI 0·78–0·91) per female living with HIV in 2019, 0·99 male infections (0·91–1·10) for every female infection, and 1·02 male deaths (0·95–1·10) per female death. Global progress in incident cases and deaths between 2010 and 2019 was driven by sub-Saharan Africa (with a 28·52% decrease in incident cases, 95% UI 19·58–35·43, and a 39·66% decrease in deaths, 36·49–42·36). Elsewhere, the incidence remained stable or increased, whereas deaths generally decreased. In 2019, the global incidence-to-prevalence ratio was 0·05 (95% UI 0·05–0·06) and the global incidence-to-mortality ratio was 1·94 (1·76–2·12). No regions met suggested thresholds for progress. Interpretation: Sub-Saharan Africa had both the highest HIV burden and the greatest progress between 1990 and 2019. The number of incident cases and deaths in males and females approached parity in 2019, although there remained more females with HIV than males with HIV. Globally, the HIV epidemic is far from the UNAIDS benchmarks on progress metrics. Funding: The Bill & Melinda Gates Foundation, the National Institute of Mental Health of the US National Institutes of Health (NIH), and the National Institute on Aging of the NIH.