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 language | English |
---|---|
Journal | The Lancet HIV |
DOIs | |
Publication status | Accepted/In press - 2016 |
ASJC Scopus subject areas
- Infectious Diseases
- Epidemiology
- Immunology
- Virology
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Estimates of global, regional, and national incidence, prevalence, and mortality of HIV, 1980-2015 : The Global Burden of Disease Study 2015. / Wang, Haidong; Wolock, Timothy M.; Carter, Austin et al.
In: The Lancet HIV, 2016.Research output: Contribution to journal › Article › peer-review
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TY - JOUR
T1 - Estimates of global, regional, and national incidence, prevalence, and mortality of HIV, 1980-2015
T2 - The Global Burden of Disease Study 2015
AU - Wang, Haidong
AU - Wolock, Timothy M.
AU - Carter, Austin
AU - Nguyen, Grant
AU - Kyu, Hmwe
AU - Gakidou, Emmanuela
AU - Hay, Simon
AU - Mills, Edward J.
AU - Trickey, Adam
AU - Msemburi, William T.
AU - Coates, Matthew M.
AU - Mooney, Meghan D.
AU - Fraser, Maya S.
AU - Sligar, Amber
AU - Salomon, Joshua A.
AU - Larson, Heidi
AU - Friedman, Joseph
AU - Abajobir, Amanuel Alemu
AU - Abate, Kalkidan Hassen
AU - Abbas, Kaja M.
AU - Razek, Mohamed Magdy Abd El
AU - Abd-Allah, Foad
AU - Abdulle, Abdishakur M.
AU - Abera, Semaw F.
AU - Abubakar, Ibrahim
AU - Abu-Raddad, Laith J.
AU - Abu-Rmeileh, Niveen
AU - Abyu, Gebre Yitayih
AU - Adebiyi, Akindele Olupelumi
AU - Adedeji, Isaac Akinkunmi
AU - Adelekan, Ademola
AU - Adofo, Koranteng
AU - Adou, Arsène K.
AU - Ajala, Oluremi N.
AU - Akinyemiju, Tomi F.
AU - Akseer, Nadia
AU - Lami, Faris Hasan Al
AU - Al-Aly, Ziyad
AU - Alam, Khurshid
AU - Alam, Noore K M
AU - Alasfoor, Deena
AU - Aldhahri, Saleh Fahed S
AU - Aldridge, Robert William
AU - Alegretti, Miguel A.
AU - Aleman, Alicia V.
AU - Alemu, Zewdie Aderaw
AU - Alfonso-Cristancho, Rafael
AU - Ali, Raghib
AU - Alkerwi, Ala'a
AU - Alla, François
AU - Mohammad, Rajaa
AU - Al-Raddadi, Salem
AU - Alsharif, Ubai
AU - Alvarez, Elena
AU - Alvis-Guzman, Nelson
AU - Amare, Azmeraw T.
AU - Amberbir, Alemayehu
AU - Amegah, Adeladza Kofi
AU - Ammar, Walid
AU - Amrock, Stephen Marc
AU - Antonio, Carl Abelardo T
AU - Anwari, Palwasha
AU - Ärnlöv, Johan
AU - Artaman, Al
AU - Asayesh, Hamid
AU - Asghar, Rana J.
AU - Assadi, Reza
AU - Atique, Suleman
AU - Atkins, Lydia S.
AU - Avokpaho, Euripide Frinel G Arthur
AU - Awasthi, Ashish
AU - Quintanilla, Beatriz Paulina Ayala
AU - Bacha, Umar
AU - Badawi, Alaa
AU - Barac, Aleksandra
AU - Bärnighausen, Till
AU - Basu, Arindam
AU - Bayou, Tigist Assefa
AU - Bayou, Yibeltal Tebekaw
AU - Bazargan-Hejazi, Shahrzad
AU - Beardsley, Justin
AU - Bedi, Neeraj
AU - Bennett, Derrick A.
AU - Bensenor, Isabela M.
AU - Betsu, Balem Demtsu
AU - Beyene, Addisu Shunu
AU - Bhatia, Eesh
AU - Bhutta, Zulfiqar
AU - Biadgilign, Sibhatu
AU - Bikbov, Boris
AU - Birlik, Sait Mentes
AU - Bisanzio, Donal
AU - Brainin, Michael
AU - Bražinová, Alexandra
AU - Breitborde, Nicholas J K
AU - Brown, Alexandria
AU - Burch, Michael
AU - Butt, Zahid A.
AU - Campuzano, Julio C.
AU - Cardenas, Rosario
AU - Carrero, Juan Jesus
AU - Castaneda-Orjuela, Carlos A.
AU - Rivas, Jacqueline Castillo
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AU - Chang, Jung Chen
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AU - Chen, Wanqing
AU - Chiang, Peggy P.
AU - Chibalabala, Mirriam
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AU - das Neves, José
AU - de Jager, Pieter
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AU - Dellavalle, Robert P.
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AU - Jonas, Jost B.
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AU - Kayibanda, Jeanne Françoise
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AU - Kemp, Andrew H.
AU - Kengne, Andrew Pascal
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AU - Khader, Yousef S.
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AU - Khan, Ejaz Ahmad
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AU - Kim, Yun Jin
AU - Kinfu, Yohannes
AU - Kivipelto, M.
AU - Kokubo, Yoshihiro
AU - Kosen, Soewarta
AU - Koul, Parvaiz A.
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AU - Bicer, Burcu Kucuk
AU - Kulkarni, Veena S.
AU - Kumar, G. Anil
AU - Lal, Dharmesh Kumar
AU - Lam, Hilton
AU - Lam, Jennifer O.
AU - Langan, Sinead M.
AU - Lansingh, Van C.
AU - Larsson, Anders
AU - Leigh, James
AU - Leung, Ricky
AU - Li, Yongmei
AU - Lim, Stephen S.
AU - Lipshultz, Steven E.
AU - Liu, Shiwei
AU - Lloyd, Belinda K.
AU - Logroscino, Giancarlo
AU - Lotufo, Paulo A.
AU - Lunevicius, Raimundas
AU - Razek, Hassan Magdy Abd El
AU - Mahdavi, Mahdi
AU - Majdan, Marek
AU - Majeed, Azeem
AU - Makhlouf, Carla
AU - Malekzadeh, Reza
AU - Mapoma, Christopher C.
AU - Marcenes, Wagner
AU - Martinez-Raga, Jose
AU - Marzan, Melvin B.
AU - Masiye, Felix
AU - Mason-Jones, Amanda J.
AU - Mayosi, Bongani M.
AU - McKee, Martin
AU - Meaney, Peter A.
AU - Mehndiratta, Man Mohan
AU - Mekonnen, Alemayehu B.
AU - Melaku, Yohannes A.
AU - Memiah, Peter
AU - Memish, Ziad
AU - Mendoza, Walter
AU - Meretoja, Atte
AU - Meretoja, Tuomo J.
AU - Mhimbira, Francis Apolinary
AU - Miller, Ted R.
AU - Mikesell, Joseph
AU - Mirarefin, Mojde
AU - Mohammad, Karzan Abdulmuhsin
AU - Mohammed, Shafiu
AU - Mokdad, Ali H.
AU - Monasta, Lorenzo
AU - Moradi-Lakeh, Maziar
AU - Mori, Rintaro
AU - Mueller, Ulrich O.
AU - Murimira, Brighton
AU - Murthy, Gudlavalleti Venkata Satyanarayana
AU - Naheed, Aliya
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PY - 2016
Y1 - 2016
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=84978901278&partnerID=8YFLogxK
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U2 - 10.1016/S2352-3018(16)30087-X
DO - 10.1016/S2352-3018(16)30087-X
M3 - Article
JO - The Lancet HIV
JF - The Lancet HIV
SN - 2352-3018
ER -