A Comprehensive Review of Empirical and Modeled HIV Incidence Trends (1990-2012)
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World Bank Group, Washington, DC
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An accurate measurement of HIV incidence
is a key for policy makers and HIV program managers
directing national HIV response. However, there is no
perfect method to measure or estimate the rate at which new
HIV infections occur in a population. This review compiles
and triangulates longitudinal HIV incidence and prevalence
data from published studies and trials, national reports and
surveys, and the Joint United Nations Programme on HIV/AIDS
estimates from the Spectrum model, focusing on 20 countries
in Sub-Saharan Africa with generalized HIV epidemics. Three
main points can be taken from this analysis of HIV incidence
trends. First, modeled HIV incidence and nationally reported
HIV prevalence levels in young females suggest that national
HIV incidence has declined since 2000 in all except three
countries analyzed (stable estimated HIV trends in Burkina
Faso, Burundi, and Uganda), but trial and survey data
suggest that in some demographics, HIV incidence remains
critically high. Second, all modeled national HIV incidence
curves and most empirically observed trends commenced a
downward trajectory prior to the introduction of
anti-retroviral therapy programs around 2004, suggesting the
contribution of other factors, such as HIV prevention
programs and natural epidemic dynamics, to this decline.
Third, modeled HIV incidence estimates, including the
incidence peaks in the past, exhibit much variation between
Spectrum model versions and when new data are added,
emphasizing the uncertainty of model outputs and the need to
use incidence estimates with caution.
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ACQUIRED IMMUNE DEFICIENCY SYNDROME, ADULT POPULATION, AGE GROUPS, AGED, AIDS EPIDEMIC, AIDS IMPACT, AIDS PROGRAM, AIDS RELIEF, ANTENATAL CLINIC, ANTENATAL CLINICS, ANTIBODIES, ARVS, BOTH SEXES, CASES OF HIV, CHANGE IN POPULATION, CLINICAL TRIALS, CLINICS, COMPLICATIONS, DEPARTMENT OF POPULATION, DEVELOPMENT EFFORTS, DEVELOPMENT POLICY, DISEASE, DISEASE CONTROL, DRUGS, EMERGENCY PLAN, ENZYME IMMUNOASSAY, EPIDEMIC, EPIDEMICS, EPIDEMIOLOGICAL DATA, EPIDEMIOLOGY, FAMILY PLANNING, FEMALE, FEMALE SEX WORKERS, FEMALES, FERTILITY PATTERNS, GLOBAL AIDS EPIDEMIC, GLOBAL AIDS RESPONSE, GLOBAL HIV/AIDS, HEALTH POPULATION, HEALTH SURVEYS, HIGH-RISK GROUPS, HIV, HIV DATA, HIV EPIDEMICS, HIV INFECTION, HIV INFECTIONS, HIV POSITIVE, HIV PREVALENCE, HIV PREVENTION, HIV TRANSMISSION, HIV/AIDS, HUMAN DEVELOPMENT, HUMAN IMMUNODEFICIENCY VIRUS, HYGIENE, IMMUNE DEFICIENCY, IMMUNODEFICIENCY, INHERENT BIASES, LARGE POPULATION, LONGER LIVES, LOWER FERTILITY, MILLENNIUM DEVELOPMENT GOAL, MINISTRY OF HEALTH, MORTALITY, MORTALITY RATES, MOTHER, MOTHER-TO-CHILD, MOTHER-TO-CHILD TRANSMISSION, NATIONAL AIDS, NATIONAL LEVEL, NATIONAL LEVELS, NATIONAL POPULATION, NATIONAL PROGRESS, NEW CASES, NEW INFECTIONS, NUCLEIC ACID, NUMBER OF NEW INFECTIONS, NUTRITION, OLDER ADULTS, OLDER AGE GROUPS, OLDER PEOPLE, PATIENT, PATIENTS, PERSONAL COMMUNICATION, POLICY DISCUSSIONS, POLICY MAKERS, POLICY RESEARCH, POLICY RESEARCH WORKING PAPER, POPULATION DYNAMICS, POPULATION RESEARCH, POPULATION RESEARCH CENTRE, POPULOUS COUNTRY, PREGNANT WOMEN, PREVALENCE, PREVENTION EFFORTS, PREVENTION STRATEGIES, PROGRESS, REGIONAL STRATEGIES, RISK FACTORS, RISK POPULATIONS, SERVICE PROVISION, SEX, SEX DISTRIBUTION, SEX WORKERS, SEXUAL ACTIVITY, SEXUAL BEHAVIOR, SEXUAL BEHAVIORS, SEXUAL TRANSMISSION, SEXUALLY ACTIVE, SEXUALLY ACTIVE WOMEN, SURVEILLANCE DATA, THERAPY, TREATMENT, TROPICAL MEDICINE, UNAIDS, UNIVERSAL ACCESS, VIRAL LOAD, VIRAL LOADS, VOLUNTARY COUNSELING, YOUNG ADULTS, YOUNG AGES, YOUNG MEN, YOUNG PEOPLE, YOUNG WOMEN, YOUTH