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

Emily Haeuser; Audrey L Serfes; Michael A Cork; Mingyou Yang; Hedayat Abbastabar; E S Abhilash; Maryam Adabi; Oladimeji M Adebayo; Victor Adekanmbi; Daniel Adedayo Adeyinka; Saira Afzal; Bright Opoku Ahinkorah; Keivan Ahmadi; Muktar Beshir Ahmed; Yonas Akalu; Rufus Olusola Akinyemi; Chisom Joyqueenet Akunna; Fares Alahdab; Fahad Mashhour Alanezi; Turki M Alanzi; Kefyalew Addis Alene; Robert Kaba Alhassan; Vahid Alipour; Amir Almasi-Hashiani; Nelson Alvis-Guzman; Edward Kwabena Ameyaw; Saeed Amini; Dickson A Amugsi; Robert Ancuceanu; Davood Anvari; Seth Christopher Yaw Appiah; Jalal Arabloo; Olatunde Aremu; Mulusew A Asemahagn; Mohammad Asghari Jafarabadi; Atalel Fentahun Awedew; Beatriz Paulina Ayala Quintanilla; Martin Amogre Ayanore; Yared Asmare Aynalem; Samad Azari; Zelalem Nigussie Azene; B B Darshan; Tesleem Kayode Babalola; Atif Amin Baig; Maciej Banach; Till Winfried Bärnighausen; Arielle Wilder Bell; Akshaya Srikanth Bhagavathula; Mostafa Dianatinasab; Local Burden of Disease sub-Saharan Africa HIV Prevalence Collaborators

doi:10.1186/s12916-022-02639-z

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

Emily Haeuser^*, Audrey L Serfes, Michael A Cork, Mingyou Yang, Hedayat Abbastabar, E S Abhilash, Maryam Adabi, Oladimeji M Adebayo, Victor Adekanmbi, Daniel Adedayo Adeyinka, Saira Afzal, Bright Opoku Ahinkorah, Keivan Ahmadi, Muktar Beshir Ahmed, Yonas Akalu, Rufus Olusola Akinyemi, Chisom Joyqueenet Akunna, Fares Alahdab, Fahad Mashhour Alanezi, Turki M AlanziKefyalew Addis Alene, Robert Kaba Alhassan, Vahid Alipour, Amir Almasi-Hashiani, Nelson Alvis-Guzman, Edward Kwabena Ameyaw, Saeed Amini, Dickson A Amugsi, Robert Ancuceanu, Davood Anvari, Seth Christopher Yaw Appiah, Jalal Arabloo, Olatunde Aremu, Mulusew A Asemahagn, Mohammad Asghari Jafarabadi, Atalel Fentahun Awedew, Beatriz Paulina Ayala Quintanilla, Martin Amogre Ayanore, Yared Asmare Aynalem, Samad Azari, Zelalem Nigussie Azene, B B Darshan, Tesleem Kayode Babalola, Atif Amin Baig, Maciej Banach, Till Winfried Bärnighausen, Arielle Wilder Bell, Akshaya Srikanth Bhagavathula, Mostafa Dianatinasab, Local Burden of Disease sub-Saharan Africa HIV Prevalence Collaborators

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

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.

Original language	English
Article number	488
Number of pages	24
Journal	BMC Medicine
Volume	20
Issue number	1
DOIs	https://doi.org/10.1186/s12916-022-02639-z
Publication status	Published - 19 Dec 2022

Keywords

Male
Female
Adult
Humans
Pregnancy
Adolescent
Young Adult
Middle Aged
HIV
Acquired Immunodeficiency Syndrome/epidemiology
Prevalence
Seroepidemiologic Studies
HIV Infections/prevention & control
Africa South of the Sahara/epidemiology

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Haeuser, E., Serfes, A. L., Cork, M. A., Yang, M., Abbastabar, H., Abhilash, E. S., Adabi, M., Adebayo, O. M., Adekanmbi, V., Adeyinka, D. A., Afzal, S., Ahinkorah, B. O., Ahmadi, K., Ahmed, M. B., Akalu, Y., Akinyemi, R. O., Akunna, C. J., Alahdab, F., Alanezi, F. M., ... Local Burden of Disease sub-Saharan Africa HIV Prevalence Collaborators (2022). Mapping age- and sex-specific HIV prevalence in adults in sub-Saharan Africa, 2000-2018. BMC Medicine, 20(1), Article 488. https://doi.org/10.1186/s12916-022-02639-z

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

abstract = "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.",

keywords = "Male, Female, Adult, Humans, Pregnancy, Adolescent, Young Adult, Middle Aged, HIV, Acquired Immunodeficiency Syndrome/epidemiology, Prevalence, Seroepidemiologic Studies, HIV Infections/prevention & control, Africa South of the Sahara/epidemiology",

author = "Emily Haeuser and Serfes, {Audrey L} and Cork, {Michael A} and Mingyou Yang and Hedayat Abbastabar and Abhilash, {E S} and Maryam Adabi and Adebayo, {Oladimeji M} and Victor Adekanmbi and Adeyinka, {Daniel Adedayo} and Saira Afzal and Ahinkorah, {Bright Opoku} and Keivan Ahmadi and Ahmed, {Muktar Beshir} and Yonas Akalu and Akinyemi, {Rufus Olusola} and Akunna, {Chisom Joyqueenet} and Fares Alahdab and Alanezi, {Fahad Mashhour} and Alanzi, {Turki M} and Alene, {Kefyalew Addis} and Alhassan, {Robert Kaba} and Vahid Alipour and Amir Almasi-Hashiani and Nelson Alvis-Guzman and Ameyaw, {Edward Kwabena} and Saeed Amini and Amugsi, {Dickson A} and Robert Ancuceanu and Davood Anvari and Appiah, {Seth Christopher Yaw} and Jalal Arabloo and Olatunde Aremu and Asemahagn, {Mulusew A} and Jafarabadi, {Mohammad Asghari} and Awedew, {Atalel Fentahun} and Quintanilla, {Beatriz Paulina Ayala} and Ayanore, {Martin Amogre} and Aynalem, {Yared Asmare} and Samad Azari and Azene, {Zelalem Nigussie} and Darshan, {B B} and Babalola, {Tesleem Kayode} and Baig, {Atif Amin} and Maciej Banach and B{\"a}rnighausen, {Till Winfried} and Bell, {Arielle Wilder} and Bhagavathula, {Akshaya Srikanth} and Mostafa Dianatinasab and {Local Burden of Disease sub-Saharan Africa HIV Prevalence Collaborators}",

note = "{\textcopyright} 2022. The Author(s).",

year = "2022",

month = dec,

day = "19",

doi = "10.1186/s12916-022-02639-z",

language = "English",

volume = "20",

journal = "BMC Medicine",

issn = "1741-7015",

publisher = "BioMed Central Ltd",

number = "1",

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Haeuser, E, Serfes, AL, Cork, MA, Yang, M, Abbastabar, H, Abhilash, ES, Adabi, M, Adebayo, OM, Adekanmbi, V, Adeyinka, DA, Afzal, S, Ahinkorah, BO, Ahmadi, K, Ahmed, MB, Akalu, Y, Akinyemi, RO, Akunna, CJ, Alahdab, F, Alanezi, FM, Alanzi, TM, Alene, KA, Alhassan, RK, Alipour, V, Almasi-Hashiani, A, Alvis-Guzman, N, Ameyaw, EK, Amini, S, Amugsi, DA, Ancuceanu, R, Anvari, D, Appiah, SCY, Arabloo, J, Aremu, O, Asemahagn, MA, Jafarabadi, MA, Awedew, AF, Quintanilla, BPA, Ayanore, MA, Aynalem, YA, Azari, S, Azene, ZN, Darshan, BB, Babalola, TK, Baig, AA, Banach, M, Bärnighausen, TW, Bell, AW, Bhagavathula, AS, Dianatinasab, M & Local Burden of Disease sub-Saharan Africa HIV Prevalence Collaborators 2022, 'Mapping age- and sex-specific HIV prevalence in adults in sub-Saharan Africa, 2000-2018', BMC Medicine, vol. 20, no. 1, 488. https://doi.org/10.1186/s12916-022-02639-z

TY - JOUR

T1 - Mapping age- and sex-specific HIV prevalence in adults in sub-Saharan Africa, 2000-2018

AU - Haeuser, Emily

AU - Serfes, Audrey L

AU - Cork, Michael A

AU - Yang, Mingyou

AU - Abbastabar, Hedayat

AU - Abhilash, E S

AU - Adabi, Maryam

AU - Adebayo, Oladimeji M

AU - Adekanmbi, Victor

AU - Adeyinka, Daniel Adedayo

AU - Afzal, Saira

AU - Ahinkorah, Bright Opoku

AU - Ahmadi, Keivan

AU - Ahmed, Muktar Beshir

AU - Akalu, Yonas

AU - Akinyemi, Rufus Olusola

AU - Akunna, Chisom Joyqueenet

AU - Alahdab, Fares

AU - Alanezi, Fahad Mashhour

AU - Alanzi, Turki M

AU - Alene, Kefyalew Addis

AU - Alhassan, Robert Kaba

AU - Alipour, Vahid

AU - Almasi-Hashiani, Amir

AU - Alvis-Guzman, Nelson

AU - Ameyaw, Edward Kwabena

AU - Amini, Saeed

AU - Amugsi, Dickson A

AU - Ancuceanu, Robert

AU - Anvari, Davood

AU - Appiah, Seth Christopher Yaw

AU - Arabloo, Jalal

AU - Aremu, Olatunde

AU - Asemahagn, Mulusew A

AU - Jafarabadi, Mohammad Asghari

AU - Awedew, Atalel Fentahun

AU - Quintanilla, Beatriz Paulina Ayala

AU - Ayanore, Martin Amogre

AU - Aynalem, Yared Asmare

AU - Azari, Samad

AU - Azene, Zelalem Nigussie

AU - Darshan, B B

AU - Babalola, Tesleem Kayode

AU - Baig, Atif Amin

AU - Banach, Maciej

AU - Bärnighausen, Till Winfried

AU - Bell, Arielle Wilder

AU - Bhagavathula, Akshaya Srikanth

AU - Dianatinasab, Mostafa

AU - Local Burden of Disease sub-Saharan Africa HIV Prevalence Collaborators

PY - 2022/12/19

Y1 - 2022/12/19

N2 - 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.

AB - 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.

KW - Male

KW - Female

KW - Adult

KW - Humans

KW - Pregnancy

KW - Adolescent

KW - Young Adult

KW - Middle Aged

KW - HIV

KW - Acquired Immunodeficiency Syndrome/epidemiology

KW - Prevalence

KW - Seroepidemiologic Studies

KW - HIV Infections/prevention & control

KW - Africa South of the Sahara/epidemiology

U2 - 10.1186/s12916-022-02639-z

DO - 10.1186/s12916-022-02639-z

M3 - Article

C2 - 36529768

SN - 1741-7015

VL - 20

JO - BMC Medicine

JF - BMC Medicine

IS - 1

M1 - 488

ER -

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

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Keywords

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