• 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, Bright Opoku Ahinkorah, Keivan Ahmadi, Muktar Beshir Ahmed, Yonas Akalu, Rufus Olusola Akinyemi, Chisom Joyqueenet Akunna, Fares Alahdab, Fahad Mashhour Alanezi, Turki M Alanzi, Kefyalew Addis Alene, Robert Kaba Alhassan, Vahid Alipour, Amir Almasi-Hashiani, Nelson Alvis-Guzman, Edward Kwabena Ameyaw, Saeed Amini, Dickson A Amugsi, Robert Ancuceanu, Davood Anvari, Seth Christopher Yaw Appiah, Jalal Arabloo, Olatunde Aremu, Mulusew A Asemahagn, JafarabadiMohammad AsghariMADepartment of Biostatistics and Epidemiology, Tabriz University of Medical Sciences, Tabriz, Iran.Department of Biostatistics and Epidemiology, Zanjan University of Medical Sciences, Zanjan, Iran., Atalel Fentahun Awedew, QuintanillaBeatriz Paulina AyalaBPAThe Judith Lumley Centre, La Trobe University, Melbourne, VIC, Australia.San Martin de Porres University, Lima, Peru., 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, DartehEugene Kofuor MaafoEKMDepartment of Population and Health, University of Cape Coast, Cape Coast, Ghana., 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, 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, Mohammad Rifat Haider, Arvin Haj-Mirzaian, Samer Hamidi, Abdiwahab Hashi, Soheil Hassanipour, Hadi Hassankhani, Khezar Hayat, Claudiu Herteliu, Hung Chak Ho, Ramesh Holla, 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, 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, Tanuj Kanchan, MatinBehzad KaramiBKResearch Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran., Salah Eddin Karimi, Gbenga A Kayode, Ali Kazemi Karyani, Maryam Keramati, Ejaz Ahmad Khan, Gulfaraz Khan, Md Nuruzzaman Khan, Khaled Khatab, 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, Nuworza Kugbey, Vaman Kulkarni, Manasi Kumar, Nithin Kumar, Dian Kusuma, Carlo La Vecchia, Dharmesh Kumar Lal, Iván Landires, Heidi Jane Larson, Savita Lasrado, 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, Tuomo J Meretoja, Tomislav Mestrovic, Andreea Mirica, Babak Moazen, Osama Mohamad, Yousef Mohammad, Abdollah Mohammadian-Hafshejani, Reza Mohammadpourhodki, Salahuddin Mohammed, Shafiu Mohammed, 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, Rawlance Ndejjo, Ionut Negoi, Frida N Ngalesoni, Georges Nguefack-Tsague, Josephine W Ngunjiri, NguyenCuong TatCTInstitute for Global Health Innovations, Duy Tan University, Hanoi, Vietnam., Huong Lan Thi Nguyen, Chukwudi A Nnaji, Jean Jacques Noubiap, Virginia Nuñez-Samudio, 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, 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, Shrikant Pawar, Emmanuel K Peprah, Maarten J Postma, Liliana Preotescu, Zahiruddin Quazi Syed, Navid Rabiee, Amir Radfar, Alireza Rafiei, Fakher Rahim, Vafa Rahimi-Movaghar, 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, Aziz Rezapour, Mavra A Riaz, Ana Isabel Ribeiro, Jennifer M Ross, Enrico Rubagotti, Susan Fred Rumisha, Godfrey M Rwegerera, MoghaddamSahar SaeediSSNon-communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran., Rajesh Sagar, Biniyam Sahiledengle, Maitreyi Sahu, Marwa Rashad Salem, KafilHossein SamadiHSDrug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran., Abdallah M Samy, Benn Sartorius, Brijesh Sathian, Abdul-Aziz Seidu, Amira A Shaheen, Masood Ali Shaikh, Morteza Shamsizadeh, 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, 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, Giang Thu Vu, Yohannes Dibaba Wado, Yasir Waheed, Richard G Wamai, Yanzhong Wang, Paul Ward, Nuwan Darshana Wickramasinghe, Katherine Wilson, Sanni Yaya, Paul Yip, Naohiro Yonemoto, Chuanhua Yu, Mikhail Sergeevich Zastrozhin, Yunquan Zhang, Zhi-Jiang Zhang, Simon I Hay, Laura Dwyer-Lindgren, and Local Burden of Disease sub-Saharan Africa HIV Prevalence Collaborators.
• Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA. ehaeuser@uw.edu.
• Bmc Med. 2022 Dec 19; 20 (1): 488488.

BackgroundHuman 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.MethodsWe 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.ResultsWe 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.ConclusionsAs 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.© 2022. The Author(s).

24 keywords...

hide…