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3. Estimates of global, regional, and national incidence, prevalence, and mortality of HIV, 1980-2015: the Global Burden of Disease Study 2015

Author

Wang, Haidong, Wolock, Tim M, Carter, Austin, Nguyen, Grant, Kyu, Hmwe Hmwe, Gakidou, Emmanuela, Hay, Simon I, Mills, Edward J, Trickey, Adam, Msemburi, William, Coates, Matthew M, Mooney, Meghan D, Fraser, Maya S, Sligar, Amber, Salomon, Joshua, Larson, Heidi J, Friedman, Joseph, Abajobir, Amanuel Alemu, Abate, Kalkidan Hassen, Abbas, Kaja M, Razek, Mohamed Magdy Abd El, Abd-Allah, Foad, Abdulle, Abdishakur M, Abera, Semaw Ferede, Abubakar, Ibrahim, Abu-Raddad, Laith J, Abu-Rmeileh, Niveen M E, Abyu, Gebre Yitayih, Adebiyi, Akindele Olupelumi, Adedeji, Isaac Akinkunmi, Adelekan, Ademola Lukman, Adofo, Koranteng, Adou, Arsène Kouablan, Ajala, Oluremi N, Akinyemiju, Tomi F, Akseer, Nadia, Lami, Faris Hasan Al, Al-Aly, Ziyad, Alam, Khurshid, Alam, Noore K M, Alasfoor, Deena, Aldhahri, Saleh Fahed S, Aldridge, Robert William, Alegretti, Miguel Angel, Aleman, Alicia V, Alemu, Zewdie Aderaw, Alfonso-Cristancho, Rafael, Ali, Raghib, Alkerwi, Ala'a, Alla, François, Mohammad, Rajaa, Al-Raddadi, Salem, Alsharif, Ubai, Alvarez, Elena, Alvis-Guzman, Nelson, Amare, Azmeraw T, Amberbir, Alemayehu, Amegah, Adeladza Kofi, Ammar, Walid, Amrock, Stephen Marc, Antonio, Carl Abelardo T, Anwari, Palwasha, Ärnlöv, Johan, Artaman, Al, Asayesh, Hamid, Asghar, Rana Jawad, Assadi, Reza, Atique, Suleman, Atkins, Lydia S, Avokpaho, Euripide Frinel G Arthur, Awasthi, Ashish, Quintanilla, Beatriz Paulina Ayala, Bacha, Umar, Badawi, Alaa, Barac, Aleksandra, Bärnighausen, Till, Basu, Arindam, Bayou, Tigist Assefa, Bayou, Yibeltal Tebekaw, Bazargan-Hejazi, Shahrzad, Beardsley, Justin, Bedi, Neeraj, Bennett, Derrick A, Bensenor, Isabela M, Betsu, Balem Demtsu, Beyene, Addisu Shunu, Bhatia, Eesh, Bhutta, Zulfiqar A, Biadgilign, Sibhatu, Bikbov, Boris, Birlik, Sait Mentes, Bisanzio, Donal, Brainin, Michael, Brazinova, Alexandra, Breitborde, Nicholas J K, Brown, Alexandria, Burch, Michael, Butt, Zahid A, Campuzano, Julio Cesar, Cárdenas, Rosario, Carrero, Juan Jesus, Castañeda-Orjuela, Carlos A, Rivas, Jacqueline Castillo, Catalá-López, Ferrán, Chang, Hsing-Yi, Chang, Jung-chen, Chavan, Laxmikant, Chen, Wanqing, Chiang, Peggy Pei-Chia, Chibalabala, Mirriam, Chisumpa, Vesper Hichilombwe, Choi, Jee-Young Jasmine, Christopher, Devasahayam Jesudas, Ciobanu, Liliana G, Cooper, Cyrus, Dahiru, Tukur, Damtew, Solomon Abrha, Dandona, Lalit, Dandona, Rakhi, das Neves, José, de Jager, Pieter, De Leo, Diego, Degenhardt, Louisa, Dellavalle, Robert P, Deribe, Kebede, Deribew, Amare, Des Jarlais, Don C, Dharmaratne, Samath D, Ding, Eric L, Doshi, Pratik Pinal, Doyle, Kerrie E, Driscoll, Tim R, Dubey, Manisha, Elshrek, Yousef Mohamed, Elyazar, Iqbal, Endries, Aman Yesuf, Ermakov, Sergey Petrovich, Eshrati, Babak, Esteghamati, Alireza, Faghmous, Imad D A, Farinha, Carla Sofia e Sa, Faro, Andre, Farvid, Maryam S, Farzadfar, Farshad, Fereshtehnejad, Seyed-Mohammad, Fernandes, Joao C, Fischer, Florian, Fitchett, Joseph Robert Anderson, Foigt, Nataliya, Fullman, Nancy, Fürst, Thomas, Gankpé, Fortuné Gbètoho, Gebre, Teshome, Gebremedhin, Amanuel Tesfay, Gebru, Alemseged Aregay, Geleijnse, Johanna M, Gessner, Bradford D, Gething, Peter W, Ghiwot, Tsegaye Tewelde, Giroud, Maurice, Gishu, Melkamu Dedefo, Glaser, Elizabeth, Goenka, Shifalika, Goodridge, Amador, Gopalani, Sameer Vali, Goto, Atsushi, Gugnani, Harish Chander, Guimaraes, Mark D C, Gupta, Rahul, Gupta, Rajeev, Gupta, Vipin, Haagsma, Juanita, Hafezi-Nejad, Nima, Hagan, Holly, Hailu, Gessessew Bugssa, Hamadeh, Randah Ribhi, Hamidi, Samer, Hammami, Mouhanad, Hankey, Graeme J, Hao, Yuantao, Harb, Hilda L, Harikrishnan, Sivadasanpillai, Haro, Josep Maria, Harun, Kimani M, Havmoeller, Rasmus, Hedayati, Mohammad T, Heredia-Pi, Ileana Beatriz, Hoek, Hans W, Horino, Masako, Horita, Nobuyuki, Hosgood, H Dean, Hoy, Damian G, Hsairi, Mohamed, Hu, Guoqing, Huang, Hsiang, Huang, John J, Iburg, Kim Moesgaard, Idrisov, Bulat T, Innos, Kaire, Iyer, Veena J, Jacobsen, Kathryn H, Jahanmehr, Nader, Jakovljevic, Mihajlo B, Javanbakht, Mehdi, Jayatilleke, Achala Upendra, Jeemon, Panniyammakal, Jha, Vivekanand, Jiang, Guohong, Jiang, Ying, Jibat, Tariku, Jonas, Jost B, Kabir, Zubair, Kamal, Ritul, Kan, Haidong, Karch, André, Karema, Corine Kakizi, Karletsos, Dimitris, Kasaeian, Amir, Kaul, Anil, Kawakami, Norito, Kayibanda, Jeanne Françoise, Keiyoro, Peter Njenga, Kemp, Andrew Haddon, Kengne, Andre Pascal, Kesavachandran, Chandrasekharan Nair, Khader, Yousef Saleh, Khalil, Ibrahim, Khan, Abdur Rahman, Khan, Ejaz Ahmad, Khang, Young-Ho, Khubchandani, Jagdish, Kim, Yun Jin, Kinfu, Yohannes, Kivipelto, Miia, Kokubo, Yoshihiro, Kosen, Soewarta, Koul, Parvaiz A, Koyanagi, Ai, Defo, Barthelemy Kuate, Bicer, Burcu Kucuk, Kulkarni, Veena S, Kumar, G Anil, Lal, Dharmesh Kumar, Lam, Hilton, Lam, Jennifer O, Langan, Sinead M, Lansingh, Van C, Larsson, Anders, Leigh, James, Leung, Ricky, Li, Yongmei, Lim, Stephen S, Lipshultz, Steven E, Liu, Shiwei, Lloyd, Belinda K, Logroscino, Giancarlo, Lotufo, Paulo A, Lunevicius, Raimundas, Razek, Hassan Magdy Abd El, Mahdavi, Mahdi, Mahesh, P A, Majdan, Marek, Majeed, Azeem, Makhlouf, Carla, Malekzadeh, Reza, Mapoma, Chabila C, Marcenes, Wagner, Martinez-Raga, Jose, Marzan, Melvin Barrientos, Masiye, Felix, Mason-Jones, Amanda J, Mayosi, Bongani M, McKee, Martin, Meaney, Peter A, Mehndiratta, Man Mohan, Mekonnen, Alemayehu B, Melaku, Yohannes Adama, Memiah, Peter, Memish, Ziad A, Mendoza, Walter, Meretoja, Atte, Meretoja, Tuomo J, Mhimbira, Francis Apolinary, Miller, Ted R, Mikesell, Joseph, Mirarefin, Mojde, Mohammad, Karzan Abdulmuhsin, Mohammed, Shafiu, Mokdad, Ali H, Monasta, Lorenzo, Moradi-Lakeh, Maziar, Mori, Rintaro, Mueller, Ulrich O, Murimira, Brighton, Murthy, Gudlavalleti Venkata Satyanarayana, Naheed, Aliya, Naldi, Luigi, Nangia, Vinay, Nash, Denis, Nawaz, Haseeb, Nejjari, Chakib, Ngalesoni, Frida Namnyak, de Dieu Ngirabega, Jean, Nguyen, Quyen Le, Nisar, Muhammad Imran, Norheim, Ole F, Norman, Rosana E, Nyakarahuka, Luke, Ogbo, Felix Akpojene, Oh, In-Hwan, Ojelabi, Foluke Adetola, Olusanya, Bolajoko Olubukunola, Olusanya, Jacob Olusegun, Opio, John Nelson, Oren, Eyal, Ota, Erika, Park, Hye-Youn, Park, Jae-Hyun, Patil, Snehal T, Patten, Scott B, Paul, Vinod K, Pearson, Katherine, Peprah, Emmanuel Kwame, Pereira, David M, Perico, Norberto, Pesudovs, Konrad, Petzold, Max, Phillips, Michael Robert, Pillay, Julian David, Plass, Dietrich, Polinder, Suzanne, Pourmalek, Farshad, Prokop, David M, Qorbani, Mostafa, Rafay, Anwar, Rahimi, Kazem, Rahimi-Movaghar, Vafa, Rahman, Mahfuzar, Rahman, Mohammad Hifz Ur, Rahman, Sajjad Ur, Rai, Rajesh Kumar, Rajsic, Sasa, Ram, Usha, Rana, Saleem M, Rao, Paturi Vishnupriya, Remuzzi, Giuseppe, Rojas-Rueda, David, Ronfani, Luca, Roshandel, Gholamreza, Roy, Ambuj, Ruhago, George Mugambage, Saeedi, Mohammad Yahya, Sagar, Rajesh, Saleh, Muhammad Muhammad, Sanabria, Juan R, Santos, Itamar S, Sarmiento-Suarez, Rodrigo, Sartorius, Benn, Sawhney, Monika, Schutte, Aletta E, Schwebel, David C, Seedat, Soraya, Sepanlou, Sadaf G, Servan-Mori, Edson E, Shaikh, Masood Ali, Sharma, Rajesh, She, Jun, Sheikhbahaei, Sara, Shen, Jiabin, Shibuya, Kenji, Shin, Hwashin Hyun, Sigfusdottir, Inga Dora, Silpakit, Naris, Silva, Diego Augusto Santos, Silveira, Dayane Gabriele Alves, Simard, Edgar P, Sindi, Shireen, Singh, Jasvinder A, Singh, Om Prakash, Singh, Prashant Kumar, Skirbekk, Vegard, Sliwa, Karen, Soneji, Samir, Sorensen, Reed J D, Soriano, Joan B, Soti, David O, Sreeramareddy, Chandrashekhar T, Stathopoulou, Vasiliki, Steel, Nicholas, Sunguya, Bruno F, Swaminathan, Soumya, Sykes, Bryan L, Tabarés-Seisdedos, Rafael, Talongwa, Roberto Tchio, Tavakkoli, Mohammad, Taye, Bineyam, Tedla, Bemnet Amare, Tekle, Tesfaye, Shifa, Girma Temam, Temesgen, Awoke Misganaw, Terkawi, Abdullah Sulieman, Tesfay, Fisaha Haile, Tessema, Gizachew Assefa, Thapa, Kiran, Thomson, Alan J, Thorne-Lyman, Andrew L, Tobe-Gai, Ruoyan, Topor-Madry, Roman, Towbin, Jeffrey Allen, Tran, Bach Xuan, Dimbuene, Zacharie Tsala, Tsilimparis, Nikolaos, Tura, Abera Kenay, Ukwaja, Kingsley Nnanna, Uneke, Chigozie Jesse, Uthman, Olalekan A, Venketasubramanian, N, Vladimirov, Sergey K, Vlassov, Vasiliy Victorovich, Vollset, Stein Emil, Wang, Linhong, Weiderpass, Elisabete, Weintraub, Robert G, Werdecker, Andrea, Westerman, Ronny, Wijeratne, Tissa, Wilkinson, James D, Wiysonge, Charles Shey, Wolfe, Charles D A, Won, Sungho, Wong, John Q, Xu, Gelin, Yadav, Ajit Kumar, Yakob, Bereket, Yalew, Ayalnesh Zemene, Yano, Yuichiro, Yaseri, Mehdi, Yebyo, Henock Gebremedhin, Yip, Paul, Yonemoto, Naohiro, Yoon, Seok-Jun, Younis, Mustafa Z, Yu, Chuanhua, Yu, Shicheng, Zaidi, Zoubida, Zaki, Maysaa El Sayed, Zeeb, Hajo, Zhang, Hao, Zhao, Yong, Zodpey, Sanjay, Zoeckler, Leo, Zuhlke, Liesl Joanna, Lopez, Alan D, Murray, Christopher J L, Health Services Management & Organisation (HSMO), Public Health, and İç Hastalıkları

Subjects
Time Factors, Incidence, Immunology, HIV Infections, Articles, Global Health, Article, CD4 Lymphocyte Count, Global Burden of Disease, Young Adult, Infectious Diseases, SDG 3 - Good Health and Well-being, Seroepidemiologic Studies, Antiretroviral Therapy, Highly Active, Prevalence, Humans
Abstract

Background: timely assessment of the burden of HIV/AIDS is essential for policy setting and programme evaluation. In this report from the Global Burden of Disease Study 2015 (GBD 2015), we provide national estimates of levels and trends of HIV/AIDS incidence, prevalence, coverage of antiretroviral therapy (ART), and mortality for 195 countries and territories from 1980 to 2015.Methods: for countries without high-quality vital registration data, we estimated prevalence and incidence with data from antenatal care clinics and population-based seroprevalence surveys, and with assumptions by age and sex on initial CD4 distribution at infection, CD4 progression rates (probability of progression from higher to lower CD4 cell-count category), on and off antiretroviral therapy (ART) mortality, and mortality from all other causes. Our estimation strategy links the GBD 2015 assessment of all-cause mortality and estimation of incidence and prevalence so that for each draw from the uncertainty distribution all assumptions used in each step are internally consistent. We estimated incidence, prevalence, and death with GBD versions of the Estimation and Projection Package (EPP) and Spectrum software originally developed by the Joint United Nations Programme on HIV/AIDS (UNAIDS). We used an open-source version of EPP and recoded Spectrum for speed, and used updated assumptions from systematic reviews of the literature and GBD demographic data. For countries with high-quality vital registration data, we developed the cohort incidence bias adjustment model to estimate HIV incidence and prevalence largely from the number of deaths caused by HIV recorded in cause-of-death statistics. We corrected these statistics for garbage coding and HIV misclassification.Findings: global HIV incidence reached its peak in 1997, at 3·3 million new infections (95% uncertainty interval [UI] 3·1–3·4 million). Annual incidence has stayed relatively constant at about 2·6 million per year (range 2·5–2·8 million) since 2005, after a period of fast decline between 1997 and 2005. The number of people living with HIV/AIDS has been steadily increasing and reached 38·8 million (95% UI 37·6–40·4 million) in 2015. At the same time, HIV/AIDS mortality has been declining at a steady pace, from a peak of 1·8 million deaths (95% UI 1·7–1·9 million) in 2005, to 1·2 million deaths (1·1–1·3 million) in 2015. We recorded substantial heterogeneity in the levels and trends of HIV/AIDS across countries. Although many countries have experienced decreases in HIV/AIDS mortality and in annual new infections, other countries have had slowdowns or increases in rates of change in annual new infections.Interpretation: scale-up of ART and prevention of mother-to-child transmission has been one of the great successes of global health in the past two decades. However, in the past decade, progress in reducing new infections has been slow, development assistance for health devoted to HIV has stagnated, and resources for health in low-income countries have grown slowly. Achievement of the new ambitious goals for HIV enshrined in Sustainable Development Goal 3 and the 90-90-90 UNAIDS targets will be challenging, and will need continued efforts from governments and international agencies in the next 15 years to end AIDS by 2030.FundingBill & Melinda Gates Foundation, and National Institute of Mental Health and National Institute on Aging, National Institutes of Health

Published
2016

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