Background: The sustainable development goals (SDGs) aim to end HIV/AIDS as a public health threat by 2030. Understanding the current state of the HIV epidemic and its change over time is essential to this effort. Thi...
Background: The sustainable development goals (SDGs) aim to end HIV/AIDS as a public health threat by 2030. Understanding the current state of the HIV epidemic and its change over time is essential to this effort. This study assesses the current sex-specific HIV burden in 204 countries and territories and measures progress in the control of the epidemic. Methods: To estimate age-specific and sex-specific trends in 48 of 204 countries, we extended the Estimation and Projection Package Age-Sex Model to also implement the spectrum paediatric model. We used this model in cases where age and sex specific HIV-seroprevalence surveys and antenatal care-clinic sentinel surveillance data were available. For the remaining 156 of 204 locations, we developed a cohort-incidence bias adjustment to derive incidence as a function of cause-of-death data from vital registration systems. The incidence was input to a custom Spectrum model. To assess progress, we measured the percentage change in incident cases and deaths between 2010 and 2019 (threshold >75% decline), the ratio of incident cases to number of people living with HIV (incidence-to-prevalence ratio threshold <0·03), and the ratio of incident cases to deaths (incidence-to-mortality ratio threshold <1·0). Findings: In 2019, there were 36·8 million (95% uncertainty interval [UI] 35·1–38·9) people living with HIV worldwide. There were 0·84 males (95% UI 0·78–0·91) per female living with HIV in 2019, 0·99 male infections (0·91–1·10) for every female infection, and 1·02 male deaths (0·95–1·10) per female death. Global progress in incident cases and deaths between 2010 and 2019 was driven by sub-Saharan Africa (with a 28·52% decrease in incident cases, 95% UI 19·58–35·43, and a 39·66% decrease in deaths, 36·49–42·36). Elsewhere, the incidence remained stable or increased, whereas deaths generally decreased. In 2019, the global incidence-to-prevalence ratio was 0·05 (95% UI 0·05–0·06) and the global incidence-to-mortality ratio was
作者：
Felicia Olmeta-SchultLauren Massa SegalSam TynerTwila Alexandra MoonRyan Dz-Wei ChowProsanta ChakrabartyMartin PacesaAnna Igorevna PodgornaiaJennifer ChenBipin SinghBo CaoRishi Raj Singh SidhuBryce W Q TanPrashant SoodStuart ParkerMatthew A ScultDesiree Van HauteNikos KonstantinidesBeat A SchwendimannSudhakar SrivastavaRaffaele FiorenzaKen Dutton-RegesterRachel HaleEmre Ozan PolatEdward LauAudrey L MayerEaston R WhiteEnvironmental and Natural Resource Sciences
Washington State University Vancouver WA 98686 USA. folmeta@wsu.edu lsegal3@*** sctyner@iastate.edu twila.science@*** ryan.chow@yale.edu prosanta@lsu.edu m.pacesa@bioc.uzh.ch anna.podgornaia@*** jennifer.s.chen@yale.edu bipin.singh@bmu.edu.in bocao@*** rishirajsidhu@*** brycetan03@*** drprashantsood@*** parkstua@isu.edu matthew.scult@duke.edu desireevanhaute@*** nk1845@nyu.edu beat.schwendimann@*** sudhakar.srivastava@*** ralphie.fiorenza@*** ken.dutton-regester@qimrberghofer.edu.au r.hale@soton.ac.uk emre-ozan.polat@icfo.es lau1@stanford.edu almayer@mtu.edu eawhite@ucdavis.edu. Department of Plant Pathology
University of Nebraska-Lincoln Lincoln NE 68583 USA. folmeta@wsu.edu lsegal3@*** sctyner@iastate.edu twila.science@*** ryan.chow@yale.edu prosanta@lsu.edu m.pacesa@bioc.uzh.ch anna.podgornaia@*** jennifer.s.chen@yale.edu bipin.singh@bmu.edu.in bocao@*** rishirajsidhu@*** brycetan03@*** drprashantsood@*** parkstua@isu.edu matthew.scult@duke.edu desireevanhaute@*** nk1845@nyu.edu beat.schwendimann@*** sudhakar.srivastava@*** ralphie.fiorenza@*** ken.dutton-regester@qimrberghofer.edu.au r.hale@soton.ac.uk emre-ozan.polat@icfo.es lau1@stanford.edu almayer@mtu.edu eawhite@ucdavis.edu. Center for Statistics and Applications in Forensic Evidence
Iowa State University Ames IA 50014 USA. folmeta@wsu.edu lsegal3@*** sctyner@iastate.edu twila.science@*** ryan.chow@yale.edu prosanta@lsu.edu m.pacesa@bioc.uzh.ch anna.podgornaia@*** jennifer.s.chen@yale.edu bipin.singh@bmu.edu.in bocao@*** rishirajsidhu@*** brycetan03@*** drprashantsood@*** parkstua@isu.edu matthew.scult@duke.edu desireevanhaute@*** nk1845@nyu.edu beat.schwendimann@*** sudhakar.srivastava@*** ralphie.fiorenza@*** ken.dutton-regester@qimrberghofer.edu.au r.hale@soton.ac.uk emre-ozan.polat@icfo.es lau1@stanford.edu almayer@mtu.edu eawhite@ucdavis.edu. National Snow and Ice Data Center
University of Colorado Boulder CO 80309 USA. folmeta@wsu.edu lsegal3@gmail.com sctyner@iastate.edu twila.science@gma
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