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; Abhay Motiramji Gaidhane; Birhan Gebresillassie Gebregiorgis; Ketema Bizuwork Gebremedhin; Lemma Getacher; Keyghobad Ghadiri; Ahmad Ghashghaee; Mahaveer Golechha; Mohammed Ibrahim Mohialdeen Gubari; Harish Chander Gugnani; Rafael Alves Guimarães; Bright Opoku Ahinkorah; Mohammad Rifat Haider; Arvin Haj-Mirzaian; Samer Hamidi; Abdiwahab Hashi; Soheil Hassanipour; Hadi Hassankhani; Khezar Hayat; Claudiu Herteliu; Hung Chak Ho; Ramesh Holla; Keivan Ahmadi; Mostafa Hosseini; Mehdi Hosseinzadeh; Bing-Fang Hwang; Segun Emmanuel Ibitoye; Olayinka Stephen Ilesanmi; Irena M Ilic; Milena D Ilic; Rakibul M Islam; Chidozie C D Iwu; Mihajlo Jakovljevic; Muktar Beshir Ahmed; 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; Yonas Akalu; 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; Rufus Olusola Akinyemi; Jagdish Khubchandani; Yun Jin Kim; Adnan Kisa; Sezer Kisa; Jacek A Kopec; Soewarta Kosen; Sindhura Lakshmi Koulmane Laxminarayana; Ai Koyanagi; Kewal Krishan; Barthelemy Kuate Defo; Chisom Joyqueenet Akunna; Nuworza Kugbey; Vaman Kulkarni; Manasi Kumar; Nithin Kumar; Dian Kusuma; Carlo La Vecchia; Dharmesh Kumar Lal; Iván Landires; Heidi Jane Larson; Savita Lasrado; Fares Alahdab; Paul H Lee; Shanshan Li; Xuefeng Liu; Afshin Maleki; Preeti Malik; Mohammad Ali Mansournia; Francisco Rogerlândio Martins-Melo; Walter Mendoza; Ritesh G Menezes; Endalkachew Worku Mengesha; Fahad Mashhour Alanezi; Tuomo J Meretoja; Tomislav Mestrovic; Andreea Mirica; Babak Moazen; Osama Mohamad; Yousef Mohammad; Abdollah Mohammadian-Hafshejani; Reza Mohammadpourhodki; Salahuddin Mohammed; Shafiu Mohammed; Turki M Alanzi; Ali H Mokdad; Masoud Moradi; Paula Moraga; Sumaira Mubarik; Getaneh Baye B Mulu; Lillian Mwanri; Ahamarshan Jayaraman Nagarajan; Mukhammad David Naimzada; Muhammad Naveed; Javad Nazari; Kefyalew Addis Alene; Rawlance Ndejjo; Ionut Negoi; Frida N Ngalesoni; Georges Nguefack-Tsague; Josephine W Ngunjiri; Cuong Tat Nguyen; Huong Lan Thi Nguyen; Chukwudi A Nnaji; Jean Jacques Noubiap; Virginia Nuñez-Samudio; Robert Kaba Alhassan; Vincent Ebuka Nwatah; Bogdan Oancea; Oluwakemi Ololade Odukoya; Andrew T Olagunju; Babayemi Oluwaseun Olakunde; Bolajoko Olubukunola Olusanya; Jacob Olusegun Olusanya; Ahmed Omar Bali; Obinna E Onwujekwe; Orish Ebere Orisakwe; Vahid Alipour; Nikita Otstavnov; Stanislav S Otstavnov; Mayowa O Owolabi; P A Mahesh; Jagadish Rao Padubidri; Adrian Pana; Ashok Pandey; Seithikurippu R Pandi-Perumal; Fatemeh Pashazadeh Kan; George C Patton; Amir Almasi-Hashiani; Shrikant Pawar; Emmanuel K Peprah; Maarten J Postma; Liliana Preotescu; Zahiruddin Quazi Syed; Navid Rabiee; Amir Radfar; Alireza Rafiei; Fakher Rahim; Vafa Rahimi-Movaghar; Nelson Alvis-Guzman; Amir Masoud Rahmani; Kiana Ramezanzadeh; Juwel Rana; Chhabi Lal Ranabhat; Sowmya J Rao; David Laith Rawaf; Salman Rawaf; Reza Rawassizadeh; Lemma Demissie Regassa; Nima Rezaei; Edward Kwabena Ameyaw; Aziz Rezapour; Mavra A Riaz; Ana Isabel Ribeiro; Jennifer M Ross; Enrico Rubagotti; Susan Fred Rumisha; Godfrey M Rwegerera; Sahar Saeedi Moghaddam; Rajesh Sagar; Biniyam Sahiledengle; Saeed Amini; 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; Dickson A Amugsi; Wondimeneh Shibabaw Shiferaw; Jae Il Shin; Roman Shrestha; Jasvinder A Singh; Valentin Yurievich Skryabin; Anna Aleksandrovna Skryabina; Shahin Soltani; Mu'awiyyah Babale Sufiyan; Takahiro Tabuchi; Eyayou Girma Tadesse; Robert Ancuceanu; Nuno Taveira; Fisaha Haile Tesfay; Rekha Thapar; Marcos Roberto Tovani-Palone; Gebiyaw Wudie Tsegaye; Chukwuma David Umeokonkwo; Bhaskaran Unnikrishnan; Jorge Hugo Villafañe; Francesco S Violante; Bay Vo; Davood Anvari; Giang Thu Vu; Yohannes Dibaba Wado; Yasir Waheed; Richard G Wamai; Yanzhong Wang; Paul Ward; Nuwan Darshana Wickramasinghe; Katherine Wilson; Sanni Yaya; Paul Yip; Seth Christopher Yaw Appiah; Naohiro Yonemoto; Chuanhua Yu; Mikhail Sergeevich Zastrozhin; Yunquan Zhang; Zhi-Jiang Zhang; Simon I Hay; Laura Dwyer-Lindgren; Local Burden of Disease sub-Saharan Africa HIV Prevalence Collaborators; 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; Nikha Bhardwaj; Pankaj Bhardwaj; Krittika Bhattacharyya; Ali Bijani; Zebenay Workneh Bitew; Somayeh Bohlouli; Obasanjo Afolabi Bolarinwa; Archith Boloor; Ivana Bozicevic; Zahid A Butt; Rosario Cárdenas; Felix Carvalho; Jaykaran Charan; Vijay Kumar Chattu; Mohiuddin Ahsanul Kabir Chowdhury; Dinh-Toi Chu; Richard G Cowden; Saad M A Dahlawi; Giovanni Damiani; Eugene Kofuor Maafo Darteh; 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-Jaafary; Babak Eshrati; Sharareh Eskandarieh; Oghenowede Eyawo; Ifeanyi Jude Ezeonwumelu; 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

doi:10.1186/s12916-022-02639-z

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

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 Adeyinka ; Saira Afzal ; Abhay Motiramji Gaidhane ; Birhan Gebresillassie Gebregiorgis ; Ketema Bizuwork Gebremedhin ; Lemma Getacher ; Keyghobad Ghadiri ; Ahmad Ghashghaee ; Mahaveer Golechha ; Mohammed Ibrahim Mohialdeen Gubari ; Harish Chander Gugnani ; Rafael Alves Guimarães ; Bright Opoku Ahinkorah ; Mohammad Rifat Haider ; Arvin Haj-Mirzaian ; Samer Hamidi ; Abdiwahab Hashi ; Soheil Hassanipour ; Hadi Hassankhani ; Khezar Hayat ; Claudiu Herteliu ; Hung Chak Ho ; Ramesh Holla ; Keivan Ahmadi ; Mostafa Hosseini ; Mehdi Hosseinzadeh ; Bing-Fang Hwang ; Segun Emmanuel Ibitoye ; Olayinka Stephen Ilesanmi ; Irena M Ilic ; Milena D Ilic ; Rakibul M Islam ; Chidozie C D Iwu ; Mihajlo Jakovljevic ; Muktar Beshir Ahmed ; 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 ; Yonas Akalu ; 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 ; Rufus Olusola Akinyemi ; Jagdish Khubchandani ; Yun Jin Kim ; Adnan Kisa ; Sezer Kisa ; Jacek A Kopec ; Soewarta Kosen ; Sindhura Lakshmi Koulmane Laxminarayana ; Ai Koyanagi ; Kewal Krishan ; Barthelemy Kuate Defo ; Chisom Joyqueenet Akunna ; Nuworza Kugbey ; Vaman Kulkarni ; Manasi Kumar ; Nithin Kumar ; Dian Kusuma ; Carlo La Vecchia ; Dharmesh Kumar Lal ; Iván Landires ; Heidi Jane Larson ; Savita Lasrado ; Fares Alahdab ; Paul H Lee ; Shanshan Li ; Xuefeng Liu ; Afshin Maleki ; Preeti Malik ; Mohammad Ali Mansournia ; Francisco Rogerlândio Martins-Melo ; Walter Mendoza ; Ritesh G Menezes ; Endalkachew Worku Mengesha ; Fahad Mashhour Alanezi ; Tuomo J Meretoja ; Tomislav Mestrovic ; Andreea Mirica ; Babak Moazen ; Osama Mohamad ; Yousef Mohammad ; Abdollah Mohammadian-Hafshejani ; Reza Mohammadpourhodki ; Salahuddin Mohammed ; Shafiu Mohammed ; Turki M Alanzi ; Ali H Mokdad ; Masoud Moradi ; Paula Moraga ; Sumaira Mubarik ; Getaneh Baye B Mulu ; Lillian Mwanri ; Ahamarshan Jayaraman Nagarajan ; Mukhammad David Naimzada ; Muhammad Naveed ; Javad Nazari ; Kefyalew Addis Alene ; Rawlance Ndejjo ; Ionut Negoi ; Frida N Ngalesoni ; Georges Nguefack-Tsague ; Josephine W Ngunjiri ; Cuong Tat Nguyen ; Huong Lan Thi Nguyen ; Chukwudi A Nnaji ; Jean Jacques Noubiap ; Virginia Nuñez-Samudio ; Robert Kaba Alhassan ; Vincent Ebuka Nwatah ; Bogdan Oancea ; Oluwakemi Ololade Odukoya ; Andrew T Olagunju ; Babayemi Oluwaseun Olakunde ; Bolajoko Olubukunola Olusanya ; Jacob Olusegun Olusanya ; Ahmed Omar Bali ; Obinna E Onwujekwe ; Orish Ebere Orisakwe ; Vahid Alipour ; Nikita Otstavnov ; Stanislav S Otstavnov ; Mayowa O Owolabi ; P A Mahesh ; Jagadish Rao Padubidri ; Adrian Pana ; Ashok Pandey ; Seithikurippu R Pandi-Perumal ; Fatemeh Pashazadeh Kan ; George C Patton ; Amir Almasi-Hashiani ; Shrikant Pawar ; Emmanuel K Peprah ; Maarten J Postma ; Liliana Preotescu ; Zahiruddin Quazi Syed ; Navid Rabiee ; Amir Radfar ; Alireza Rafiei ; Fakher Rahim ; Vafa Rahimi-Movaghar ; Nelson Alvis-Guzman ; Amir Masoud Rahmani ; Kiana Ramezanzadeh ; Juwel Rana ; Chhabi Lal Ranabhat ; Sowmya J Rao ; David Laith Rawaf ; Salman Rawaf ; Reza Rawassizadeh ; Lemma Demissie Regassa ; Nima Rezaei ; Edward Kwabena Ameyaw ; Aziz Rezapour ; Mavra A Riaz ; Ana Isabel Ribeiro ; Jennifer M Ross ; Enrico Rubagotti ; Susan Fred Rumisha ; Godfrey M Rwegerera ; Sahar Saeedi Moghaddam ; Rajesh Sagar ; Biniyam Sahiledengle ; Saeed Amini ; 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 ; Dickson A Amugsi ; Wondimeneh Shibabaw Shiferaw ; Jae Il Shin ; Roman Shrestha ; Jasvinder A Singh ; Valentin Yurievich Skryabin ; Anna Aleksandrovna Skryabina ; Shahin Soltani ; Mu'awiyyah Babale Sufiyan ; Takahiro Tabuchi ; Eyayou Girma Tadesse ; Robert Ancuceanu ; Nuno Taveira ; Fisaha Haile Tesfay ; Rekha Thapar ; Marcos Roberto Tovani-Palone ; Gebiyaw Wudie Tsegaye ; Chukwuma David Umeokonkwo ; Bhaskaran Unnikrishnan ; Jorge Hugo Villafañe ; Francesco S Violante ; Bay Vo ; Davood Anvari ; Giang Thu Vu ; Yohannes Dibaba Wado ; Yasir Waheed ; Richard G Wamai ; Yanzhong Wang ; Paul Ward ; Nuwan Darshana Wickramasinghe ; Katherine Wilson ; Sanni Yaya ; Paul Yip ; Seth Christopher Yaw Appiah ; Naohiro Yonemoto ; Chuanhua Yu ; Mikhail Sergeevich Zastrozhin ; Yunquan Zhang ; Zhi-Jiang Zhang ; Simon I Hay ; Laura Dwyer-Lindgren ; Local Burden of Disease sub-Saharan Africa HIV Prevalence Collaborators ; 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 ; Nikha Bhardwaj ; Pankaj Bhardwaj ; Krittika Bhattacharyya ; Ali Bijani ; Zebenay Workneh Bitew ; Somayeh Bohlouli ; Obasanjo Afolabi Bolarinwa ; Archith Boloor ; Ivana Bozicevic ; Zahid A Butt ; Rosario Cárdenas ; Felix Carvalho ; Jaykaran Charan ; Vijay Kumar Chattu ; Mohiuddin Ahsanul Kabir Chowdhury ; Dinh-Toi Chu ; Richard G Cowden ; Saad M A Dahlawi ; Giovanni Damiani ; Eugene Kofuor Maafo Darteh ; 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-Jaafary ; Babak Eshrati ; Sharareh Eskandarieh ; Oghenowede Eyawo ; Ifeanyi Jude Ezeonwumelu ; 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

Citation: BMC MEDICINE, Vol.20(1) : 488, 2022-12

Journal Title: BMC MEDICINE

Issue Date: 2022-12

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

Keywords: Africa ; Demographics ; Geostatistics ; HIV ; HIV prevalence ; Mapping ; Spatial statistics

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.