Journal Article

Mapping age- and sex-specific HIV prevalence in adults in sub-Saharan Africa, 2000–2018

Salah Eddin Karimi, Chhabi Lal Ranabhat, Claudiu Herteliu, Salman Rawaf, Takeshi Fukumoto, Hung Chak Ho, Eugene Kofuor Maafo Darteh, Babayemi Oluwaseun Olakunde, Yared Asmare Aynalem, Iván Landires, Martin Amogre Ayanore, Tanuj Kanchan, Jae Il Shin, Mostafa Dianatinasab, Dharmesh Kumar Lal, Susan Fred Rumisha, Jan-Walter De Neve, Khaled Khatab, Vaman Kulkarni, Navid Rabiee, Georges Nguefack-Tsague, Mavra A. Riaz, Mayowa O. Owolabi, Kefyalew Addis Alene, P. A. Mahesh, Mohammad Asghari Jafarabadi, Samad Azari, Virginia Nuñez-Samudio, Lillian Mwanri, Rafael Alves Guimarães, Amir Masoud Rahmani, Morteza Shamsizadeh, Nuwan Darshana Wickramasinghe, Bereket Duko, Getaneh Baye B. Mulu, Richard G. Wamai, Mohammed Ibrahim Mohialdeen Gubari, Zahid A. Butt, Stanislav S. Otstavnov, Robert Kaba Alhassan, Florian Fischer, Fakher Rahim, Valentin Yurievich Skryabin, Chisom Joyqueenet Akunna, Mahaveer Golechha, Dinh-Toi Chu, Mu’awiyyah Babale Sufiyan, Francesco S. Violante, Ritesh G. Menezes, Obinna E. Onwujekwe, Huong Lan Thi Nguyen, Sayeh Ezzikouri, Brijesh Sathian, Mohiuddin Ahsanul Kabir Chowdhury, Naohir

2022

Overview

Background Human immunodeficiency virus and acquired immune deficiency syndrome (HIV/AIDS) is still among the leading causes of disease burden and mortality in sub-Saharan Africa (SSA), and the world is not on track to meet targets set for ending the epidemic by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the United Nations Sustainable Development Goals (SDGs). Precise HIV burden information is critical for effective geographic and epidemiological targeting of prevention and treatment interventions. Age- and sex-specific HIV prevalence estimates are widely available at the national level, and region-wide local estimates were recently published for adults overall. We add further dimensionality to previous analyses by estimating HIV prevalence at local scales, stratified into sex-specific 5-year age groups for adults ages 15–59 years across SSA. Methods We analyzed data from 91 seroprevalence surveys and sentinel surveillance among antenatal care clinic (ANC) attendees using model-based geostatistical methods to produce estimates of HIV prevalence across 43 countries in SSA, from years 2000 to 2018, at a 5 × 5-km resolution and presented among second administrative level (typically districts or counties) units. Results We found substantial variation in HIV prevalence across localities, ages, and sexes that have been masked in earlier analyses. Within-country variation in prevalence in 2018 was a median 3.5 times greater across ages and sexes, compared to for all adults combined. We note large within-district prevalence differences between age groups: for men, 50% of districts displayed at least a 14-fold difference between age groups with the highest and lowest prevalence, and at least a 9-fold difference for women. Prevalence trends also varied over time; between 2000 and 2018, 70% of all districts saw a reduction in prevalence greater than five percentage points in at least one sex and age group. Meanwhile, over 30% of all districts saw at least a five percentage point prevalence increase in one or more sex and age group. Conclusions As the HIV epidemic persists and evolves in SSA, geographic and demographic shifts in prevention and treatment efforts are necessary. These estimates offer epidemiologically informative detail to better guide more targeted interventions, vital for combating HIV in SSA.

• Publisher: Springer Science and Business Media LLC,BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Acquired immune deficiency syndrome / Acquired immune deficiency syndrome (AIDS) / Acquired Immunodeficiency Syndrome / Acquired Immunodeficiency Syndrome - epidemiology / Adolescent / Adult / Adults / Africa / Africa South of the Sahara / Africa South of the Sahara - epidemiology / Africa; Demographics; Geostatistics; HIV; HIV prevalence; Mapping; Spatial statistics / Age / Age groups / AIDS / Antenatal care clinic (ANC) / Biomedicine / Coronaviruses / COVID-19 / Demographic aspects / Demographics / Demography / Drug therapy / Epidemics / Epidemiology / Estimates / Female / Gender / Geostatistics / Global positioning systems / GPS / Health services / HIV / HIV infection / HIV Infections / HIV Infections - prevention & control / HIV prevalence / Human immunodeficiency virus / Human immunodeficiency virus (HIV) / Humans / Male / Males / Mapping / Medicine / Medicine & Public Health / Middle Aged / Pandemics / Pregnancy / Prenatal care / Prevalence / Prevention / Production methods / Public health / R / Research Article / Risk factors / SDG-03: Good health and well-being / Seroepidemiologic Studies / Serology / Sex / Sexually transmitted diseases / Spatial statistics / Statistics / STD / Sub-Saharan Africa (SSA) / Surveillance / Sustainable development / Sustainable development goals (SDGs) / Tracking / WA. 900 Vital Statistics / WC Communicable Diseases / Young Adult