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

• DOI: 10.1186/s12916-022-02639-z
• Publication Date: 2022-12-19T01:02:40Z
• Authors: Emily Haeuser; Audrey L. Serfes; Michael A. Cork; Mingyou Yang; Hedayat Abbastabar; E. S. Abhilash; Maryam Adabi; Oladimeji M. Adebayo; Victor Adekanmbi; Daniel Adedayo Ad...; Saira Afzal; Bright Opoku Ahin...; Keivan Ahmadi; Muktar Beshir Ahmed; Yonas Akalu; Rufus Olusola Aki...; Chisom Joyqueenet...; Fares Alahdab; Fahad Mashhour Al...; Turki M. Alanzi; Kefyalew Addis Alene; Robert Kaba Alhassan; Vahid Alipour; Amir Almasi-Hashiani; Nelson Alvis-Guzman; Edward Kwabena Am...; Saeed Amini; Dickson A. Amugsi; Robert Ancuceanu; Davood Anvari; Seth Christopher ...; Jalal Arabloo; Olatunde Aremu; Mulusew A. Asemahagn; Mohammad Asghari ...; Atalel Fentahun A...; Beatriz Paulina A...; Martin Amogre Aya...; Yared Asmare Aynalem; Samad Azari; Zelalem Nigussie ...; B. B. Darshan; Tesleem Kayode Ba...; Atif Amin Baig; Maciej Banach; Till Winfried Bär...; Arielle Wilder Bell; Akshaya Srikanth ...; Nikha Bhardwaj; Pankaj Bhardwaj; Krittika Bhattach...; Ali Bijani; Zebenay Workneh B...; Somayeh Bohlouli; Obasanjo Afolabi ...; Archith Boloor; Ivana Bozicevic; Zahid A. Butt; Rosario Cárdenas; Felix Carvalho; Jaykaran Charan; Vijay Kumar Chattu; Mohiuddin Ahsanul...; Dinh-Toi Chu; Richard G. Cowden; Saad M. A. Dahlawi; Giovanni Damiani; Eugene Kofuor Maa...; Aso Mohammad Darwesh; José das Neves; Nicole Davis Weaver; Diego De Leo; Jan-Walter De Neve; Kebede Deribe; Keshab Deuba; Samath Dharmaratne; Mostafa Dianatinasab; Daniel Diaz; Alireza Didarloo; Shirin Djalalinia; Fariba Dorostkar; Eleonora Dubljanin; Bereket Duko; Maha El Tantawi; Shaimaa I. El-Jaa...; Babak Eshrati; Sharareh Eskandarieh; Oghenowede Eyawo; Ifeanyi Jude Ezeo...; Sayeh Ezzikouri; Farshad Farzadfar; Nazir Fattahi; Nelsensius Klau Fauk; Eduarda Fernandes; Irina Filip; Florian Fischer; Nataliya A. Foigt; Masoud Foroutan; Takeshi Fukumoto; Mohamed M. Gad; Abhay Motiramji G...; Birhan Gebresilla...; Ketema Bizuwork G...; Lemma Getacher; Keyghobad Ghadiri; Ahmad Ghashghaee; Mahaveer Golechha; Mohammed Ibrahim ...; Harish Chander Gu...; Rafael Alves Guim...; Mohammad Rifat Ha...; Arvin Haj-Mirzaian; Samer Hamidi; Abdiwahab Hashi; Soheil Hassanipour; Hadi Hassankhani; Khezar Hayat; Claudiu Herteliu; Hung Chak Ho; Ramesh Holla; Mostafa Hosseini; Mehdi Hosseinzadeh; Bing-Fang Hwang; Segun Emmanuel Ib...; Olayinka Stephen ...; Irena M. Ilic; Milena D. Ilic; Rakibul M. Islam; Chidozie C. D. Iwu; Mihajlo Jakovljevic; Ravi Prakash Jha; John S. Ji; Kimberly B. Johnson; Nitin Joseph; Vasna Joshua; Farahnaz Joukar; Jacek Jerzy Jozwiak; Leila R. Kalankesh; Rohollah Kalhor; Naser Kamyari; Tanuj Kanchan; Behzad Karami Matin; Salah Eddin Karimi; Gbenga A. Kayode; Ali Kazemi Karyani; Maryam Keramati; Ejaz Ahmad Khan; Gulfaraz Khan; Md Nuruzzaman Khan; Khaled Khatab; Jagdish Khubchandani; Yun Jin Kim; Adnan Kisa; Sezer Kisa; Jacek A. Kopec; Soewarta Kosen; Sindhura Lakshmi ...; Ai Koyanagi; Kewal Krishan; Barthelemy Kuate ...; Nuworza Kugbey; Vaman Kulkarni; Manasi Kumar; Nithin Kumar; Dian Kusuma; Carlo La Vecchia; Dharmesh Kumar Lal; Iván Landires; Heidi Jane Larson; Savita Lasrado; Paul H. Lee; Shanshan Li; Xuefeng Liu; Afshin Maleki; Preeti Malik; Mohammad Ali Mans...; Francisco Rogerlâ...; Walter Mendoza; Ritesh G. Menezes; Endalkachew Worku...; Tuomo J. Meretoja; Tomislav Mestrovic; Andreea Mirica; Babak Moazen; Osama Mohamad; Yousef Mohammad; Abdollah Mohammad...; Reza Mohammadpour...; Salahuddin Mohammed; Shafiu Mohammed; Ali H. Mokdad; Masoud Moradi; Paula Moraga; Sumaira Mubarik; Getaneh Baye B. Mulu; Lillian Mwanri; Ahamarshan Jayara...; Mukhammad David N...; Muhammad Naveed; Javad Nazari; Rawlance Ndejjo; Ionut Negoi; Frida N. Ngalesoni; Georges Nguefack-...; Josephine W. Ngun...; Cuong Tat Nguyen; Huong Lan Thi Nguyen; Chukwudi A. Nnaji; Jean Jacques Noubiap; Virginia Nuñez-Sa...; Vincent Ebuka Nwatah; Bogdan Oancea; Oluwakemi Ololade...; Andrew T. Olagunju; Babayemi Oluwaseu...; Bolajoko Olubukun...; Jacob Olusegun Ol...; Ahmed Omar Bali; Obinna E. Onwujekwe; Orish Ebere Orisakwe; Nikita Otstavnov; Stanislav S. Otst...; Mayowa O. Owolabi; P. A. Mahesh; Jagadish Rao Padu...; Adrian Pana; Ashok Pandey; Seithikurippu R. ...; Fatemeh Pashazade...; George C. Patton; Shrikant Pawar; Emmanuel K. Peprah; Maarten J. Postma; Liliana Preotescu; Zahiruddin Quazi ...; Navid Rabiee; Amir Radfar; Alireza Rafiei; Fakher Rahim; Vafa Rahimi-Movaghar; Amir Masoud Rahmani; Kiana Ramezanzadeh; Juwel Rana; Chhabi Lal Ranabhat; Sowmya J. Rao; David Laith Rawaf; Salman Rawaf; Reza Rawassizadeh; Lemma Demissie Re...; Nima Rezaei; Aziz Rezapour; Mavra A. Riaz; Ana Isabel Ribeiro; Jennifer M. Ross; Enrico Rubagotti; Susan Fred Rumisha; Godfrey M. Rwegerera; Sahar Saeedi Mogh...; Rajesh Sagar; Biniyam Sahiledengle; Maitreyi Sahu; Marwa Rashad Salem; Hossein Samadi Kafil; Abdallah M. Samy; Benn Sartorius; Brijesh Sathian; Abdul-Aziz Seidu; Amira A. Shaheen; Masood Ali Shaikh; Morteza Shamsizadeh; Wondimeneh Shibab...; Jae Il Shin; Roman Shrestha; Jasvinder A. Singh; Valentin Yurievic...; Anna Aleksandrovn...; Shahin Soltani; Mu’awiyyah Babale...; Takahiro Tabuchi; Eyayou Girma Tadesse; Nuno Taveira; Fisaha Haile Tesfay; Rekha Thapar; Marcos Roberto To...; Gebiyaw Wudie Tse...; Chukwuma David Um...; Bhaskaran Unnikri...; Jorge Hugo Villafañe; Francesco S. Viol...; Bay Vo; Giang Thu Vu; Yohannes Dibaba Wado; Yasir Waheed; Richard G. Wamai; Yanzhong Wang; Paul Ward; Nuwan Darshana Wi...; Katherine Wilson; Sanni Yaya; Paul Yip; Naohiro Yonemoto; Chuanhua Yu; Mikhail Sergeevic...; Yunquan Zhang; Zhi-Jiang Zhang; Simon I. Hay; Laura Dwyer-Lindgren
• Keywords: Male; 0301 basic medicine; SDG-03: Good health and well-being; Biomedical and clinical sciences; Epidemiology; Seroprevalence; HIV Infections; HIV Epidemiology; FOS: Health sciences; 310; Medical and Health Sciences; spatial statistics; Sociology; Pregnancy; Seroepidemiologic Studies; Psychological intervention; Prevalence; HIV Infection; Geostatistics; Aetiology; mapping; Internal medicine; 360; Pediatric; Immunology and Microbiology; Psychiatry; Spatial statistics; Acquired Immunodeficiency Syndrome/epidemiology; R; Life Sciences; Pre-exposure prophylaxis; Human immunodeficiency virus (HIV); Disease burden; Middle Aged; Sustainable development goals (SDGs); Hiv Prevalence; FOS: Sociology; AIDS; Antenatal care clinic (ANC); HIV prevalence; Men who have sex with men; Infectious Diseases; Environmental health; Serology; Mapping; Emergency Medicine; HIV/AIDS; Medicine; Demographics; Female; Public Health; Acquired Immunodeficiency Syndrome* / epidemiology; Infection; Africa South of the Sahara / epidemiology; Research Article; Adult; Adolescent; Clinical Sciences; Population; Immunology; 610; HIV Transmission; HIV Infections* / prevention & control; Sub-Saharan Africa (SSA); Young Adult; 03 medical and health sciences; HIV Infections/prevention & control; Clinical Research; demographics; General & Internal Medicine; Virology; Health Sciences; Humans; geostatistics; Syphilis; Africa; Demographics; Geostatistics; HIV; HIV prevalence; Mapping; Spatial statistics; Africa South of the Sahara; Antibody; Impact of HIV Infection on Cardiovascular Health; Demography; Acquired Immunodeficiency Syndrome; Biomedical and Clinical Sciences; Prevention and Treatment of HIV/AIDS Infection; Prevention; FOS: Clinical medicine; Health sciences; HIV; Local Burden of Disease sub-Saharan Africa HIV Prevalence Collaborators; Africa South of the Sahara/epidemiology; Acquired immune deficiency syndrome (AIDS); Good Health and Well Being; Young adult; Africa; Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome; Gerontology; 2.4 Surveillance and distribution

AbstractBackgroundHuman 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.MethodsWe 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.ResultsWe 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.ConclusionsAs 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.