SEATTLE – Despite an increase in antiretroviral therapy (ART) since 2000, HIV / AIDS is still the most common cause of death in sub-Saharan Africa, according to data from the Global Burden of Disease.
A new scientific paper reveals striking variations in HIV prevalence at the provincial and district levels. This paper, published in Natural, providing appropriate geographical estimates of HIV prevalence and the number of people living with HIV to identify priority areas for health care support to reduce the burden of HIV.
"Changing the trajectory of HIV / AIDS in Africa requires that we continue to look for better ways to find out the epidemic. This paper will support policy makers and health service providers in finding HIV / AIDS hotspots at national and sub-national levels, and will help guide investment savvy a rare resource for diagnosis, prevention, and treatment, "said Dr. John Nkengasong, director of the African Center for Disease Control and Prevention (African CDC).
The study, conducted at the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, was the first to map HIV prevalence among adults aged 15-49 years comprehensively at the granular level, subnational level for all 47 countries in the sub – African tribe. The results show high variations in prevalence and changes in prevalence over time in a country.
This study is available on the IHME website at http: // www.
Since 2015, the World Health Organization has recommended ART for all people living with HIV, because early treatment allows them to live longer and healthier lives and reduce the potential for transmission of the virus. Despite the rapid increase in ART, 34% of people in East and South Africa and 60% of people in West and Central Africa who are living with HIV do not currently use treatment, according to UNAIDS. Increasing population numbers and the high incidence of HIV infection, combined with increasing life expectancy among people living with HIV (PLWHA), have caused an increase in PLWHA in sub-Saharan Africa: between 2000 and 2017, the number of people aged 15-49 years lives with HIV in sub-Saharan Africa has increased by 3 million, even when HIV prevalence has declined.
"Global funding for HIV / AIDS has declined since 2013, but our research shows a substantial burden that still exists and reveals where geographically targeted interventions might make a big difference. Our goal is to provide strong data that can be used to help prevent infection in the future. and ensure appropriate care for people living with HIV, "said Dr. IHME, Laura Dwyer-Lindgren, lead author and Assistant Professor of Health Metrics.
Key findings from this study include:
- Most countries (36 out of 47) have more than doubled prevalence differences between the second level administrative subdivisions (such as districts or departments) in 2017 (Figure 1). In a quarter of the country, the biggest difference is more than five times.
- While country-level analysis shows clear differences between countries in southern sub-Saharan Africa and across continents, sub-national level analysis reveals areas outside of sub-Saharan South Africa with high HIV prevalence, including parts of Kenya, Malawi, Uganda , and Tanzania where prevalence exceeds 10% in 2017 (Figure 1c).
- The direction and rate of change in HIV prevalence from 2000 to 2017 varies between and within countries, highlighting changing landscapes and underscoring the need for current local data.
- The spatial concentration of people living with HIV (PLWHA) varies greatly. While a large number of PLWHA are concentrated in a small number of areas, the same large number is widespread in areas with lower spatial concentrations of PLWHA.
The Bill & Melinda Gates Foundation funds this research, part of a five-year grant that enables IHME researchers and collaborators globally to map various health metrics in 5×5 square kilometers. This research is part of the IHME Local Disease Load project led by Dr. Simon I. Hay, Director of Geospatial Science at IHME and Professor of Health Metrics at the University of Washington.
These estimates highlight transnational trends, suggesting that international collaboration can help overcome persistent high prevalence in several fields.
"The work done at IHME and the Local Burden of Disease team is supported by a large network of collaborators, who play an important role in data analysis and data use published in policy. We always try to build our collaborative network and are very grateful to all who contributed to the research this, "said Dr. Hay.
This paper is based on many previously published analyzes, combining various data sources and presenting the results in a web-based visualization tool that is publicly accessible.
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About the Institute of Health Metrics and Evaluation
The Institute for Health Metrics and Evaluation (IHME) is an independent global health research organization at the University of Washington that provides rigorous and comparable measurements of the most important health problems in the world and evaluates the strategies used to overcome them. IHME makes this information widely available so policy makers have the evidence they need to make informed decisions about how to allocate resources to improve population health.
About the project Local Disease Load
IHME's Local Disease Load Project aims to produce estimates of health outcomes and related actions covering the entire continent, but to do so with excellent local resolution. Such estimates allow decision makers to target resources and health interventions appropriately, so that health policy decisions can be tailored to local areas rather than the entire country. Combining local details with broad coverage – produces estimates for subdivisions of primary (eg, state, provincial) and secondary administrations (for example, districts, municipalities) on all continents and, ultimately, the world – will provide health workers wherever tools to make local information decisions and, in the process, help everyone live longer, healthier lives. The Local Disease Load Project led by Dr. Simon I. Hay, Professor of Health Metrics at the University of Washington and Director of Geospatial Sciences at IHME.
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