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Estimating and Projecting National HIV/AIDS Epidemics

Estimating and Projecting National HIV/AIDS Epidemics. UNAIDS Reference Group on Estimates, Models and Projections. Approach to Estimates and Projections. Surveillance data. EPP/Concentrated epidemic spreadsheet. Adult HIV prevalence. UN Pop Division population estimates. Spectrum.

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Estimating and Projecting National HIV/AIDS Epidemics

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  1. Estimating and Projecting National HIV/AIDS Epidemics UNAIDS Reference Group on Estimates, Models and Projections

  2. Approach to Estimates and Projections Surveillance data EPP/Concentrated epidemic spreadsheet Adult HIV prevalence UN Pop Division population estimates Spectrum • Number infected • New infections • AIDS deaths UNAIDS epidemic patterns

  3. Standard Approach Incidence New infections Prevalence # HIV+ Mortality AIDS deaths

  4. Spectrum Approach Prevalencet Populationt HIV+t-1 HIV+t New infectionst-1,t Non-AIDS deaths of HIVt-1,t AIDS deathst-1,t

  5. Spectrum: Standard epidemic patterns • Sex ratio of prevalence • Age distribution of infection • Progression from infection to death • Adults • Children • Mother-to-child transmission • Fertility reduction

  6. Ratio of Female to Male Prevalence – Generalized Epidemics Mutasa Village 1998 Rakai trading center 1990 Mwanza urban 90-91 Mwanza roadside 90-91 Mutasa Estate 1998 Zambia DHS Uganda 1988 Masaka Rwanda 1986 Zambia rural 1999

  7. Ratio of Female to Male Prevalence – Generalized Epidemics Kenya AIDS Tanzania AIDS Ethiopia AIDS

  8. Ratio of Female to Male Prevalence – Generalized Epidemics

  9. Ratio of Female to Male Reported AIDS Cases – Concentrated Epidemics Brazil Thailand Guatemala Panama Peru Mexico

  10. Ratio of Female to Male Reported AIDS Cases – Concentrated Epidemics Brazil Thailand Guatemala Panama Peru Mexico

  11. Sex ratio of infection

  12. Age-Specific Prevalence - Males

  13. Ratio to prevalence at 25-29 - Males

  14. Ratio to prevalence at 25-29 - Males

  15. Age-Specific Prevalence - Females

  16. Ratio to prevalence at 25-29 - Females

  17. Ratio to prevalence at 25-29 - Females

  18. Age Distribution of Cumulative Reported AIDS Cases - Female

  19. Age Distribution of Cumulative Reported AIDS Cases - Male

  20. Age distribution of infection

  21. Adult HIV Prevalence – Southern Mozambique

  22. Adult HIV Prevalence – Southern Mozambique and Sex Ratio of Prevalence

  23. HIV Incidence – Southern Mozambique

  24. Male Population by Age in Mozambique

  25. HIV+ Males by Age in Southern Mozambique

  26. New Male HIV Infections by Age in Southern Mozambique

  27. New Male AIDS Cases by Age in Southern Mozambique

  28. Progression to AIDS death Median = 8.6 Median = 9.4

  29. Progression to AIDS death

  30. MTCT and fertility • Mother-to-child transmission of HIV • Default value = 32 percent • Can be changed as PMTCT programs scale-up • Fertility change due to HIV infection • 15-19 = 50% increase • 20-49 = 20% decrease

  31. Anti-retroviral therapy • Can specify the percentage of population in need of ARV that receives it • Population in need = HIV+ within two years of AIDS death without ARV • Assumption : percent of those on ARV surviving to the following year • Assumption : effect of ARV on prevalence

  32. Percent Surviving on ARVs by Annual Survival Rate

  33. Effect of ARV on Prevalence by Value of Effect Assumption

  34. Orphan Estimates • Orphan: a child under the age of 15 that has lost one or both parents • Maternal, paternal, dual, total • AIDS, non-AIDS, total

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