Estimates of global, regional, and national incidence, prevalence, and mortality of HIV, 1980-2015: The Global Burden of Disease Study 2015

Haidong Wang, Timothy M. Wolock, Austin Carter, Grant Nguyen, Hmwe Kyu, Emmanuela Gakidou, Simon Hay, Edward J. Mills, Adam Trickey, William T. Msemburi, Matthew M. Coates, Meghan D. Mooney, Maya S. Fraser, Amber Sligar, Joshua A. Salomon, Heidi Larson, Joseph Friedman, Amanuel Alemu Abajobir, Kalkidan Hassen Abate, Kaja M. AbbasMohamed Magdy Abd El Razek, Foad Abd-Allah, Abdishakur M. Abdulle, Semaw F. Abera, Ibrahim Abubakar, Laith J. Abu-Raddad, Niveen Abu-Rmeileh, Gebre Yitayih Abyu, Akindele Olupelumi Adebiyi, Isaac Akinkunmi Adedeji, Ademola Adelekan, Koranteng Adofo, Arsène K. Adou, Oluremi N. Ajala, Tomi F. Akinyemiju, Nadia Akseer, Faris Hasan Al Lami, Ziyad Al-Aly, Khurshid Alam, Noore K M Alam, Deena Alasfoor, Saleh Fahed S Aldhahri, Robert William Aldridge, Miguel A. Alegretti, Alicia V. Aleman, Zewdie Aderaw Alemu, Rafael Alfonso-Cristancho, Raghib Ali, Ala'a Alkerwi, François Alla, Rajaa Mohammad, Salem Al-Raddadi, Ubai Alsharif, Elena Alvarez, Nelson Alvis-Guzman, Azmeraw T. Amare, Alemayehu Amberbir, Adeladza Kofi Amegah, Walid Ammar, Stephen Marc Amrock, Carl Abelardo T Antonio, Palwasha Anwari, Johan Ärnlöv, Al Artaman, Hamid Asayesh, Rana J. Asghar, Reza Assadi, Suleman Atique, Lydia S. Atkins, Euripide Frinel G Arthur Avokpaho, Ashish Awasthi, Beatriz Paulina Ayala Quintanilla, Umar Bacha, Alaa Badawi, Aleksandra Barac, Till Bärnighausen, Arindam Basu, Tigist Assefa Bayou, Yibeltal Tebekaw Bayou, Shahrzad Bazargan-Hejazi, Justin Beardsley, Neeraj Bedi, Derrick A. Bennett, Isabela M. Bensenor, Balem Demtsu Betsu, Addisu Shunu Beyene, Eesh Bhatia, Zulfiqar Bhutta, Sibhatu Biadgilign, Boris Bikbov, Sait Mentes Birlik, Donal Bisanzio, Michael Brainin, Alexandra Bražinová, Nicholas J K Breitborde, Alexandria Brown, Michael Burch, Zahid A. Butt, Julio C. Campuzano, Rosario Cardenas, Juan Jesus Carrero, Carlos A. Castaneda-Orjuela, Jacqueline Castillo Rivas, Ferran Catala-Lopez, Hsing Yi Chang, Jung Chen Chang, Laxmikant Chavan, Wanqing Chen, Peggy P. Chiang, Mirriam Chibalabala, Vesper Hichilombwe Chisumpa, Jee Young Jasmine Choi, Devasahayam Jesudas Christopher, Liliana G. Ciobanu, C. Cooper, Tukur Dahiru, Solomon Abreha Damtew, Lalit Dandona, Rakhi Dandona, José das Neves, Pieter de Jager, Diego De Leo, Louisa Degenhardt, Robert P. Dellavalle, Kebede Deribe, Amare Deribew, Don C. Des Jarlais, Samath D. Dharmaratne, Eric L. Ding, Pratik Pinal Doshi, Tim R. Driscoll, Manisha Dubey, Yousef Elshrek, Iqbal Elyazar, Aman Yesuf Endries, Sergey P. Ermakov, Babak Eshrati, Alireza Esteghamati, Imad D A Faghmous, Carla Sofia e Sa Farinha, Andre Faro, Maryam S. Farvid, Farshad Farzadfar, Seyed Mohammad Fereshtehnejad, Joao C. Fernandes, Florian Fischer, Joseph Robert Ander Fitchett, Nataliya Foigt, Nancy Fullman, Thomas Fürst, Fortune G. Gankpe, Teshome Gebre, Amanuel Tesfay Gebremedhin, Alemseged Aregay Gebru, Johanna M. Geleijnse, Bradford D. Gessner, Peter Gething, Tsegaye Tewelde Ghiwot, Maurice Giroud, Melkamu Dedefo Gishu, Elizabeth L. Glaser, Shifalika Goenka, Amador Goodridge, Sameer Vali Gopalani, Atsushi Goto, Harish C. Gugnani, Mark D C Guimaraes, Rahul Gupta, Rajeev Gupta, Vipin Gupta, Juanita A. Haagsma, Nima Hafezi-Nejad, Holly Hagan, Gessessew Bugssa Hailu, Randah R. Hamadeh, Samer Hamidi, Mouhanad Hammami, G. J. Hankey, Yuantao Hao, Hilda L. Harb, Sivadasanpillai Harikrishnan, J. M. Haro, Kimani M. Harun, Rasmus Havmoeller, Mohammad T. Hedayati, Ileana B. Heredia Pi, Hans W. Hoek, Masako Horino, Nobuyuki Horita, H. Dean Hosgood, Damian G. Hoy, Mohamed Hsairi, Guoqing Hu, Hsiang Huang, John J. Huang, Kim M. Iburg, Bulat T. Idrisov, Kaire Innos, Veena J. Iyer, Kathryn H. Jacobsen, Nader Jahanmehr, Mihajlo B. Jakovljevic, Mehdi Javanbakht, Achala Upendra Jayatilleke, Panniyammakal Jeemon, Vivekanand Jha, Guohong Jiang, Ying Jiang, Tariku Jibat, Jost B. Jonas, Zubair Kabir, Ritul Kamal, Haidong Kan, Andre Karch, Corine Kakizi Karema, Dimitris Karletsos, Amir Kasaeian, Anil Kaul, Norito Kawakami, Jeanne Françoise Kayibanda, Peter Njenga Keiyoro, Andrew H. Kemp, Andrew Pascal Kengne, Chandrasekharan Nair Kesavachandran, Yousef S. Khader, Ibrahim Khalil, Abdur Rahman Khan, Ejaz Ahmad Khan, Young Ho Khang, Jagdish Khubchandani, Yun Jin Kim, Yohannes Kinfu, M. Kivipelto, Yoshihiro Kokubo, Soewarta Kosen, Parvaiz A. Koul, Ai Koyanagi, Barthelemy Kuate Defo, Burcu Kucuk Bicer, Veena S. Kulkarni, G. Anil Kumar, Dharmesh Kumar Lal, Hilton Lam, Jennifer O. Lam, Sinead M. Langan, Van C. Lansingh, Anders Larsson, James Leigh, Ricky Leung, Yongmei Li, Stephen S. Lim, Steven E. Lipshultz, Shiwei Liu, Belinda K. Lloyd, Giancarlo Logroscino, Paulo A. Lotufo, Raimundas Lunevicius, Hassan Magdy Abd El Razek, Mahdi Mahdavi, Marek Majdan, Azeem Majeed, Carla Makhlouf, Reza Malekzadeh, Christopher C. Mapoma, Wagner Marcenes, Jose Martinez-Raga, Melvin B. Marzan, Felix Masiye, Amanda J. Mason-Jones, Bongani M. Mayosi, Martin McKee, Peter A. Meaney, Man Mohan Mehndiratta, Alemayehu B. Mekonnen, Yohannes A. Melaku, Peter Memiah, Ziad Memish, Walter Mendoza, Atte Meretoja, Tuomo J. Meretoja, Francis Apolinary Mhimbira, Ted R. Miller, Joseph Mikesell, Mojde Mirarefin, Karzan Abdulmuhsin Mohammad, Shafiu Mohammed, Ali H. Mokdad, Lorenzo Monasta, Maziar Moradi-Lakeh, Rintaro Mori, Ulrich O. Mueller, Brighton Murimira, Gudlavalleti Venkata Satyanarayana Murthy, Aliya Naheed, Luigi Naldi, Vinay Nangia, Denis Nash, Haseeb Nawaz, Chakib Nejjari, Frida N. Ngalesoni, Jean De Dieu Ngirabega, Quyen Le Nguyen, Muhammad I. Nisar, Ole F. Norheim, Rosana E. Norman, Luke Nyakarahuka, Felix Akpojene Ogbo, In Hwan Oh, Foluke Adetola Ojelabi, Bolajoko O. Olusanya, Jacob Olusegun Olusanya, John Nelson Opio, Eyal Oren, Erika Ota, Mahesh Anand Padukudru, Hye Youn Park, Jae Hyun Park, Snehal T. Patil, Scott B. Patten, Vinod K. Paul, Katherine Pearson, Emmanuel Kwame Peprah, Claudia C. Pereira, Norberto Perico, Konrad Pesudovs, Max Petzold, Michael R. Phillips, Julian David Pillay, Dietrich Plass, Suzanne Polinder, Farshad Pourmalek, David M. Prokop, Mostafa Qorbani, Anwar Rafay, Kazem Rahimi, Vafa Rahimi-Movaghar, Mahfuzar Rahman, Mohammad Hifz Ur Rahman, Sajjad U R Rahman, Rajesh Kumar Rai, Sasa Rajsic, Usha Ram, Saleem M. Rana, Paturi Vishnupriya Rao, Giuseppe Remuzzi, David Rojas-Rueda, Luca Ronfani, Gholamreza Roshandel, Ambuj Roy, George M. Ruhago, Mohammad Yahya Saeedi, Rajesh Sagar, Muhammad Muhammad Saleh, Juan R. Sanabria, Itamar S. Santos, Rodrigo Sarmiento-Suarez, Benn Sartorius, Monika Sawhney, Aletta Elisabeth Schutte, David C. Schwebel, S. Seedat, Sadaf G. Sepanlou, Edson E. Servan-Mori, Masood Ali Shaikh, Rajesh Sharma, Jun She, Sara Sheikhbahaei, Jiabin Shen, Kenji Shibuya, Hwashin Hyun Shin, Inga D. Sigfusdottir, Naris Silpakit, Diego Augusto Santos Silva, Dayane Gabriele Alves Silveira, Edgar P. Simard, Shireen Sindi, Jasvinder A. Singh, Om Prakash Singh, Prashant Kumar Singh, Vegard Skirbekk, Karen Sliwa, Samir Soneji, Reed J D Sorensen, Joan B. Soriano, David O. Soti, Chandrashekhar T. Sreeramareddy, Vasiliki Stathopoulou, Nicholas Steel, Bruno F. Sunguya, Soumya Swaminathan, Bryan L. Sykes, Rafael Tabares-Seisdedos, Roberto Tchio Talongwa, Mohammad Tavakkoli, Bineyam Taye, Bemnet Amare Tedla, Tesfaye Tekle, Girma Temam Shifa, Awoke Misganaw Temesgen, Abdullah Sulieman Terkawi, Fisaha Haile Tesfay, Gizachew Assefa Tessema, Kiran Thapa, Alan J. Thomson, Andrew L. Thorne-Lyman, Ruoyan Tobe-Gai, Roman Topor-Madry, Jeffrey A. Towbin, Bach X. Tran, Zacharie Tsala Dimbuene, Nikolaos Tsilimparis, Abera Kenay Tura, Kingsley N. Ukwaja, Chigozie Jesse Uneke, Olalekan A. Uthman, N. Venketasubramanian, Sergey K. Vladimirov, Vasiliy V. Vlassov, Stein Emil Vollset, Linhong Wang, Elisabete Weiderpass, Robert G. Weintraub, Andrea Werdecker, Ronny Westerman, Tissa Wijeratne, James D. Wilkinson, Charles Shey Wiysonge, Charles D A Wolfe, Sungho Won, John Q. Wong, Gelin Xu, Ajit Kumar Yadav, Bereket Yakob, Ayalnesh Zemene Yalew, Yuichiro Yano, Mehdi Yaseri, Henock Gebremedhin Yebyo, Paul Yip, Naohiro Yonemoto, Seok Jun Yoon, Mustafa Younis, Chuanhua Yu, Shicheng Yu, Zoubida Zaidi, Maysaa El Sayed Zaki, Hajo Zeeb, Hao Zhang, Yong Zhao, Sanjay Zodpey, Leo Zoeckler, Liesl Joanna Zuhlke, Alan D. Lopez, Christopher Murray

Research output: Contribution to journalArticle

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. Funding: Bill & Melinda Gates Foundation, and National Institute of Mental Health and National Institute on Aging, National Institutes of Health.

Original languageEnglish
JournalThe Lancet HIV
DOIs
Publication statusAccepted/In press - 2016

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ASJC Scopus subject areas

  • Infectious Diseases
  • Epidemiology
  • Immunology
  • Virology

Cite this

Wang, H., Wolock, T. M., Carter, A., Nguyen, G., Kyu, H., Gakidou, E., Hay, S., Mills, E. J., Trickey, A., Msemburi, W. T., Coates, M. M., Mooney, M. D., Fraser, M. S., Sligar, A., Salomon, J. A., Larson, H., Friedman, J., Abajobir, A. A., Abate, K. H., ... Murray, C. (Accepted/In press). Estimates of global, regional, and national incidence, prevalence, and mortality of HIV, 1980-2015: The Global Burden of Disease Study 2015. The Lancet HIV. https://doi.org/10.1016/S2352-3018(16)30087-X