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Global, Regional, and National Sex-Specific Burden and Control of the Hiv Epidemic, 1990–2019, for 204 Countries and Territories: The Global Burden of Diseases Study 2019 Publisher Pubmed



Jahagirdar D1 ; Walters MK1 ; Novotney A1 ; Brewer ED1 ; Frank TD7 ; Carter A1 ; Biehl MH8 ; Abbastabar H9 ; Abhilash ES19 ; Abugharbieh E20 ; Aburaddad LJ22 ; Adekanmbi V23 ; Adeyinka DA24, 25 ; Adnani QES26, 27 Show All Authors
Authors
  1. Jahagirdar D1
  2. Walters MK1
  3. Novotney A1
  4. Brewer ED1
  5. Frank TD7
  6. Carter A1
  7. Biehl MH8
  8. Abbastabar H9
  9. Abhilash ES19
  10. Abugharbieh E20
  11. Aburaddad LJ22
  12. Adekanmbi V23
  13. Adeyinka DA24, 25
  14. Adnani QES26, 27
  15. Afzal S28, 29
  16. Aghababaei S30, 31
  17. Ahinkorah BO33
  18. Ahmad S34
  19. Ahmadi K35
  20. Ahmadi S36
  21. Ahmadpour E37
  22. Ahmed MB38, 40
  23. Rashid TA41
  24. Salih YA42, 43
  25. Aklilu A44
  26. Akram T46
  27. Akunna CJ48, 49
  28. Al Hamad H50, 51
  29. Alahdab F52
  30. Alanezi FM55
  31. Aleksandrova EA56
  32. Alene KA57, 59
  33. Ali L60
  34. Alipour V61, 62
  35. Almustanyir S67, 69
  36. Alvisguzman N70, 71
  37. Ameyaw EK33
  38. Amu H72
  39. Andrei CL73
  40. Andrei T74
  41. Anvari D75, 77
  42. Arabloo J61
  43. Aremu O78
  44. Arulappan J79
  45. Atnafu DD80
  46. Quintanilla BPA87, 89
  47. Ayza MA90
  48. Azari S61
  49. Darshan BB93
  50. Banach M98, 99
  51. Barnighausen TW100, 101
  52. Barra F103
  53. Barrow A106, 107
  54. Basu S102, 108
  55. Bazarganhejazi S112, 113
  56. Belay HG114
  57. Berheto TM116
  58. Bezabhe WM86, 117
  59. Bezabih YM81, 118
  60. Bhagavathula AS119, 120
  61. Bhardwaj N122
  62. Bhardwaj P123, 124
  63. Bhattacharyya K127, 128
  64. Bibi S129
  65. Bijani A130
  66. Bisignano C1
  67. Bolarinwa OA131
  68. Boloor A132
  69. Boltaev AA135
  70. Briko NI136
  71. Buonsenso D138, 139
  72. Burkart K1, 2
  73. Butt ZA140, 141
  74. Cao C142
  75. Charan J125
  76. Chatterjee S143
  77. Chattu SK144
  78. Chattu VK145, 146
  79. Choudhari SG147
  80. Chu DT148
  81. Couto RAS149
  82. Cowden RG153
  83. Dachew BA58, 154
  84. Dadras O159, 160
  85. Dagnew AB82
  86. Dahlawi SMA53
  87. Dai X1
  88. Dandona L1, 161, 162
  89. Dandona R1, 2, 162
  90. Das Neves J150, 151
  91. Degenhardt L1, 163
  92. Demeke FM83
  93. Desta AA155
  94. Deuba K165, 166
  95. Dhamnetiya D167
  96. Dhungana GP168
  97. Dianatinasab M169, 170
  98. Diaz D171, 172
  99. Djalalinia S173
  100. Doan LP174, 175
  101. Dorostkar F63
  102. Edinur HA176
  103. Effiong A177
  104. Eftekharzadeh S179
  105. El Sayed Zaki M180
  106. Elayedath R181
  107. Elhadi M182
  108. Eljaafary SI183
  109. Elkhatib Z185
  110. Elsharkawy A184
  111. Endalamaw A84
  112. Endries AY186
  113. Eskandarieh S10
  114. Ezeonwumelu IJ187, 188
  115. Ezzikouri S189
  116. Farahmand M11
  117. Faraon EJA190
  118. Fasanmi AO191, 192
  119. Ferrero S104
  120. Desideri LF105
  121. Filip I194, 195
  122. Fischer F196
  123. Folayan MO197
  124. Foroutan M198
  125. Fukumoto T199
  126. Gad MM200, 203
  127. Gadanya MA204, 205
  128. Gaidhane AM147
  129. Garg T206
  130. Gayesa RT207
  131. Gebreyohannes EA156, 208, 209
  132. Gesesew HA91, 209
  133. Obsa AG212
  134. Ghadiri K214, 215
  135. Ghashghaee A61, 64
  136. Gilani SA216, 218
  137. Ginindza TG131
  138. Glavan IR74
  139. Glushkova EV136
  140. Golechha M219
  141. Gugnani HC220, 221
  142. Gupta B222
  143. Gupta S223
  144. Gupta VB224
  145. Gupta VK225
  146. Hamidi S226
  147. Handanagic S227
  148. Haque S228
  149. Harapan H229
  150. Hargono A230
  151. Hasaballah AI231
  152. Hashi A232
  153. Hassan S233, 234
  154. Hassanipour S235, 236
  155. Hayat K237, 238
  156. Herediapi I239
  157. Hezam K240, 241
  158. Holla R93
  159. Hoogar P94
  160. Hoque ME242
  161. Hosseini M12, 13
  162. Hosseinzadeh M61
  163. Hsairi M244
  164. Hussain R47
  165. Ibitoye SE245
  166. Idrisov B248, 249
  167. Ikuta KS1, 3
  168. Ilesanmi OS246, 250
  169. Ilic IM252
  170. Ilic MD254
  171. Irvani SSN255
  172. Islam MM88
  173. Ismail NE256
  174. Itumalla R257
  175. Iyamu IO258, 259
  176. Jabbarinejad R14, 260
  177. Jain V201
  178. Jayawardena R261, 263
  179. Jha RP167, 264
  180. Joseph N133
  181. Kabir A65
  182. Kabir Z265
  183. Kalhor R266, 267
  184. Kaliyadan F268
  185. Kamath A93, 97
  186. Kanchan T126
  187. Kandel H243, 269
  188. Kassahun G270
  189. Katoto PDMC272, 273
  190. Kayode GA274, 275
  191. Kebede EM277
  192. Kebede HK39
  193. Khajuria H278
  194. Khalid N279
  195. Khan EA280
  196. Khan G121
  197. Khatab K281, 282
  198. Kim MS283, 284
  199. Kim YJ285
  200. Kisa A286, 287
  201. Kisa S288
  202. Kochhar S4, 289
  203. Korshunov VA136
  204. Koul PA290
  205. Laxminarayana SLK291
  206. Koyanagi A292, 293
  207. Krishan K294
  208. Defo BK295, 296
  209. Kumar GA161
  210. Kumar M297, 299
  211. Kumar N133
  212. Kwarteng A301
  213. Lal DK161
  214. Landires I302, 305
  215. Lasrado S306
  216. Lassi ZS307
  217. Lazarus JV311
  218. Lee JJH5
  219. Lee YY312, 313
  220. Legrand KE1
  221. Lin C1
  222. Liu X202, 314
  223. Maddison ER1
  224. El Razek HMA315
  225. Mahasha PW316
  226. Majeed A109
  227. Makki A21
  228. Malik AA217, 319
  229. Manamo WA213
  230. Mansournia MA12
  231. Martinsmelo FR320
  232. Masoumi SZ32
  233. Memish ZA67, 68
  234. Menezes RG54
  235. Mengesha EW85
  236. Merie HE321
  237. Mersha AG157, 178
  238. Mestrovic T322, 323
  239. Meylakhs P56, 324
  240. Mheidly N326
  241. Miller TR58, 327
  242. Mirica A74
  243. Moazen B100, 328
  244. Mohammad Y329
  245. Mohammadi M330
  246. Mohammed A331
  247. Mohammed S332, 333
  248. Mohammed S332, 333
  249. Moitra M1
  250. Mokdad AH1, 2
  251. Molokhia M337
  252. Moni MA339
  253. Moradi G340, 341
  254. Moradi Y340
  255. Mpundukaambwa C210
  256. Mubarik S342
  257. Munro SB344
  258. Mwanri L209
  259. Nachega JB345, 346
  260. Nagarajan AJ348, 349
  261. Narayana AI95
  262. Naveed M350
  263. Nayak BP278
  264. Nduaguba SO351
  265. Kandel SN352
  266. Nguefacktsague G353
  267. Nguyen TH174, 175
  268. Nixon MR1
  269. Nnaji CA318, 354
  270. Noubiap JJ308
  271. Nunezsamudio V303, 304
  272. Nyirenda TE273, 355
  273. Oghenetega OB247
  274. Olagunju AT356, 357
  275. Olakunde BO358
  276. Owopetu OF251
  277. Mahesh PA359
  278. Padubidri JR93
  279. Pakhale S360
  280. Parekh T361
  281. Kan FP66
  282. Pawar S362
  283. Pepito VCF363
  284. Peprah EK325
  285. Pinheiro M152
  286. Pokhrel KN364
  287. Polibin RV136
  288. Pollok RCG365
  289. Postma MJ366, 367
  290. Syed ZQ147
  291. Radfar A368
  292. Radhakrishnan RA95
  293. Rahim F15, 369
  294. Rahimimovaghar V16
  295. Rahimzadeh S370
  296. Rahman M371
  297. Rahmani AM372
  298. Ram P193
  299. Ranabhat CL373, 374
  300. Ranasinghe P262
  301. Rao CR96
  302. Rao SJ375
  303. Rathi P93
  304. Rawaf DL110, 377
  305. Rawaf S109, 378
  306. Regassa LD379
  307. Ur Rehman I380
  308. Renzaho AMN381, 382
  309. Rezaei N17, 383
  310. Rezahosseini O384
  311. Rezai MS76
  312. Rezapour A61
  313. Ripon RK385
  314. Rodrigues V386
  315. Roshchin DO387
  316. Rwegerera GM388
  317. Saeed U389, 390
  318. Moghaddam SS18
  319. Sagar R391
  320. Saifurrahman KM392, 393
  321. Salem MR394
  322. Samaei M395
  323. Samy AM396
  324. Santricmilicevic MM252, 253
  325. Saroshe S397
  326. Sathian B50, 398
  327. Satpathy M399, 400
  328. Sawhney M401
  329. Schutte AE164, 402
  330. Seylani A403
  331. Shaikh MA404
  332. Shaka MF405
  333. Shamshad H406
  334. Shamsizadeh M407
  335. Shannawaz M408
  336. Shetty A134
  337. Shin JI409
  338. Shivakumar KM410
  339. Singh JA411, 412
  340. Skryabin VY413
  341. Skryabina AA415
  342. Somayaji R6, 416
  343. Soshnikov S249, 417
  344. Spurlock EE1
  345. Stein DJ317
  346. Sufiyan MB335
  347. Tadbiri H347
  348. Tadesse BT271, 418
  349. Tadesse EG45
  350. Tamiru AT158
  351. Tarkang EE72, 419
  352. Taveira N420, 421
  353. Tekalegn Y422
  354. Tesfay FH92, 211
  355. Tessema GA58, 309
  356. Thapar R133
  357. Tovanipalone MR423, 424
  358. Traini E276, 425
  359. Tran BX426
  360. Tsai AC427, 428
  361. Tusa BS429
  362. Ullah S129
  363. Umeokonkwo CD430
  364. Unnikrishnan B93
  365. Tahbaz SV431, 432
  366. Villafane JH433
  367. Vladimirov SK137, 434
  368. Vo B435
  369. Vongpradith A1
  370. Vu GT436
  371. Waheed Y34
  372. Wamai RG298, 437
  373. Wang G438
  374. Wang Y338
  375. Ward P209
  376. Westerman R439
  377. Winkler AS440, 441
  378. Yadav L310, 442
  379. Jabbari SHY431
  380. Yazie TS115
  381. Yi S443, 444
  382. Yigit V445
  383. Yirdaw BW158
  384. Yonemoto N446, 447
  385. Yu C342
  386. Yunusa I101, 448
  387. Zastrozhin MS414, 449
  388. Zastrozhina A450
  389. Zhang ZJ343
  390. Zumla A300, 376
  391. Salomon JA451
  392. Eaton JW1, 111
  393. Naghavi M1, 2
  394. Dwyerlindgren L1, 2
  395. Wang H1, 2
  396. Lim SS1, 2
  397. Hay SI1, 2
  398. Murray CJL1
  399. Kyu HH1, 2

Source: The Lancet HIV Published:2021


Abstract

Background: The sustainable development goals (SDGs) aim to end HIV/AIDS as a public health threat by 2030. Understanding the current state of the HIV epidemic and its change over time is essential to this effort. This study assesses the current sex-specific HIV burden in 204 countries and territories and measures progress in the control of the epidemic. Methods: To estimate age-specific and sex-specific trends in 48 of 204 countries, we extended the Estimation and Projection Package Age-Sex Model to also implement the spectrum paediatric model. We used this model in cases where age and sex specific HIV-seroprevalence surveys and antenatal care-clinic sentinel surveillance data were available. For the remaining 156 of 204 locations, we developed a cohort-incidence bias adjustment to derive incidence as a function of cause-of-death data from vital registration systems. The incidence was input to a custom Spectrum model. To assess progress, we measured the percentage change in incident cases and deaths between 2010 and 2019 (threshold >75% decline), the ratio of incident cases to number of people living with HIV (incidence-to-prevalence ratio threshold <0·03), and the ratio of incident cases to deaths (incidence-to-mortality ratio threshold <1·0). Findings: In 2019, there were 36·8 million (95% uncertainty interval [UI] 35·1–38·9) people living with HIV worldwide. There were 0·84 males (95% UI 0·78–0·91) per female living with HIV in 2019, 0·99 male infections (0·91–1·10) for every female infection, and 1·02 male deaths (0·95–1·10) per female death. Global progress in incident cases and deaths between 2010 and 2019 was driven by sub-Saharan Africa (with a 28·52% decrease in incident cases, 95% UI 19·58–35·43, and a 39·66% decrease in deaths, 36·49–42·36). Elsewhere, the incidence remained stable or increased, whereas deaths generally decreased. In 2019, the global incidence-to-prevalence ratio was 0·05 (95% UI 0·05–0·06) and the global incidence-to-mortality ratio was 1·94 (1·76–2·12). No regions met suggested thresholds for progress. Interpretation: Sub-Saharan Africa had both the highest HIV burden and the greatest progress between 1990 and 2019. The number of incident cases and deaths in males and females approached parity in 2019, although there remained more females with HIV than males with HIV. Globally, the HIV epidemic is far from the UNAIDS benchmarks on progress metrics. Funding: The Bill & Melinda Gates Foundation, the National Institute of Mental Health of the US National Institutes of Health (NIH), and the National Institute on Aging of the NIH. © 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
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