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Trends in HIV prevalence among young people in generalised epidemics: implications for monitoring the HIV epidemic

Identifieur interne : 004D51 ( Istex/Corpus ); précédent : 004D50; suivant : 004D52

Trends in HIV prevalence among young people in generalised epidemics: implications for monitoring the HIV epidemic

Auteurs : Mary Mahy ; Jesus Maria Garcia-Calleja ; Kimberly Anne Marsh

Source :

Sexually Transmitted Infections [ 1368-4973 ] ; 2012-12.

RBID : ISTEX:EE743F2D9414229ECBA287D6558DA9C4AEC7CD0B

English descriptors

Abstract

Background Countries measure trends in HIV incidence to assess the impact of HIV prevention and treatment programmes. Most countries have approximated trends in HIV incidence through modelled estimates or through trends in HIV prevalence among young people (aged 15–24 years) assuming they have recently become sexually active and have thus only been recently exposed to HIV. Methods Trends in HIV incidence are described and results are compared using three proxy measures of incidence: HIV prevalence among young women attending antenatal clinics (ANCs) in 22 countries; HIV prevalence among young male and female nationally representative household survey respondents in 14 countries; and modelled estimates of adult (ages 15–49 years) HIV incidence in 26 countries. The significance of changes in prevalence among ANC attendees and young survey respondents is tested. Results Among 26 countries, 25 had evidence of some decline in HIV incidence and 15 showed statistically significant declines in either ANC data or survey data. Only in Mozambique did the direction of the trend in young ANC attendees differ from modelled adult incidence, and in Mali and Zambia trends among young men differed from trends in adult incidence. The magnitude of change differed by method. Conclusions Trends in HIV prevalence among young people show encouraging declines. Changes in fertility patterns, HIV-infected children surviving to adulthood, and participation bias could affect future proxy measures of incidence trends.

Url:

https://api.istex.fr/document/EE743F2D9414229ECBA287D6558DA9C4AEC7CD0B/fulltext/pdf

DOI: 10.1136/sextrans-2012-050789

Links to Exploration step

ISTEX:EE743F2D9414229ECBA287D6558DA9C4AEC7CD0B

Le document en format XML

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<front><div type="abstract">Background Countries measure trends in HIV incidence to assess the impact of HIV prevention and treatment programmes. Most countries have approximated trends in HIV incidence through modelled estimates or through trends in HIV prevalence among young people (aged 15–24 years) assuming they have recently become sexually active and have thus only been recently exposed to HIV. Methods Trends in HIV incidence are described and results are compared using three proxy measures of incidence: HIV prevalence among young women attending antenatal clinics (ANCs) in 22 countries; HIV prevalence among young male and female nationally representative household survey respondents in 14 countries; and modelled estimates of adult (ages 15–49 years) HIV incidence in 26 countries. The significance of changes in prevalence among ANC attendees and young survey respondents is tested. Results Among 26 countries, 25 had evidence of some decline in HIV incidence and 15 showed statistically significant declines in either ANC data or survey data. Only in Mozambique did the direction of the trend in young ANC attendees differ from modelled adult incidence, and in Mali and Zambia trends among young men differed from trends in adult incidence. The magnitude of change differed by method. Conclusions Trends in HIV prevalence among young people show encouraging declines. Changes in fertility patterns, HIV-infected children surviving to adulthood, and participation bias could affect future proxy measures of incidence trends.</div>
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<abstract><p>Background Countries measure trends in HIV incidence to assess the impact of HIV prevention and treatment programmes. Most countries have approximated trends in HIV incidence through modelled estimates or through trends in HIV prevalence among young people (aged 15–24 years) assuming they have recently become sexually active and have thus only been recently exposed to HIV. Methods Trends in HIV incidence are described and results are compared using three proxy measures of incidence: HIV prevalence among young women attending antenatal clinics (ANCs) in 22 countries; HIV prevalence among young male and female nationally representative household survey respondents in 14 countries; and modelled estimates of adult (ages 15–49 years) HIV incidence in 26 countries. The significance of changes in prevalence among ANC attendees and young survey respondents is tested. Results Among 26 countries, 25 had evidence of some decline in HIV incidence and 15 showed statistically significant declines in either ANC data or survey data. Only in Mozambique did the direction of the trend in young ANC attendees differ from modelled adult incidence, and in Mali and Zambia trends among young men differed from trends in adult incidence. The magnitude of change differed by method. Conclusions Trends in HIV prevalence among young people show encouraging declines. Changes in fertility patterns, HIV-infected children surviving to adulthood, and participation bias could affect future proxy measures of incidence trends.</p>
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<journal-title>Sexually Transmitted Infections</journal-title>
<abbrev-journal-title abbrev-type="publisher">Sex Transm Infect</abbrev-journal-title>
<abbrev-journal-title>Sex Transm Infect</abbrev-journal-title>
<issn pub-type="ppub">1368-4973</issn>
<issn pub-type="epub">1472-3263</issn>
<publisher><publisher-name>BMJ Publishing Group Ltd</publisher-name>
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<article-meta><article-id pub-id-type="publisher-id">sextrans-2012-050789</article-id>
<article-id pub-id-type="doi">10.1136/sextrans-2012-050789</article-id>
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<article-categories><subj-group subj-group-type="heading"><subject>Supplement</subject>
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<subj-group subj-group-type="hwp-journal-coll"><subject>Open access</subject>
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<title-group><article-title>Trends in HIV prevalence among young people in generalised epidemics: implications for monitoring the HIV epidemic</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Mahy</surname>
<given-names>Mary</given-names>
</name>
<xref ref-type="aff" rid="af1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Garcia-Calleja</surname>
<given-names>Jesus Maria</given-names>
</name>
<xref ref-type="aff" rid="af2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Marsh</surname>
<given-names>Kimberly Anne</given-names>
</name>
<xref ref-type="aff" rid="af3">3</xref>
</contrib>
</contrib-group>
<aff id="af1"><label>1</label>
Evidence, Innovation and Policy Department, UNAIDS, Geneva, Switzerland</aff>
<aff id="af2"><label>2</label>
HIV Department, World Health Organization, Geneva, Switzerland</aff>
<aff id="af3"><label>3</label>
Health Protection Agency, London, UK</aff>
<author-notes><corresp><label>Correspondence to</label> Dr Mary Mahy, Evidence, Innovation and Policy Department, UNAIDS, Avenue Appia 20, Geneva 1211, Switzerland; 
<email>mahym@unaids.org</email>
</corresp>
<fn fn-type="con"><p><bold>UNAIDS Report 2012 Guest Editors</bold>
</p>
</fn>
<fn fn-type="con"><p>Karen Stanecki</p>
</fn>
<fn fn-type="con"><p>Peter D Ghys</p>
</fn>
<fn fn-type="con"><p>Geoff P Garnett</p>
</fn>
<fn fn-type="con"><p>Catherine Mercer</p>
</fn>
</author-notes>
<pub-date pub-type="ppub"><month>12</month>
<year>2012</year>
</pub-date>
<pub-date pub-type="epub"><day>20</day>
<month>11</month>
<year>2012</year>
</pub-date>
<volume>88</volume>
<volume-id pub-id-type="other">88</volume-id>
<volume-id pub-id-type="other">88</volume-id>
<issue>Suppl 2</issue>
<issue-id pub-id-type="other">sextrans;88/Suppl_2</issue-id>
<issue-id pub-id-type="other" content-type="supplement">Suppl_2</issue-id>
<issue-id pub-id-type="other">88/Suppl_2</issue-id>
<issue-title>UNAIDS Report 2012</issue-title>
<fpage>i65</fpage>
<history><date date-type="received"><day>5</day>
<month>8</month>
<year>2012</year>
</date>
<date date-type="accepted"><day>15</day>
<month>10</month>
<year>2012</year>
</date>
</history>
<permissions><copyright-statement>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</copyright-statement>
<copyright-year>2012</copyright-year>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/"><p>This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/">http://creativecommons.org/licenses/by-nc/3.0/</ext-link>
 and <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/legalcode">http://creativecommons.org/licenses/by-nc/3.0/legalcode</ext-link>
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<abstract><sec><title>Background</title>
<p>Countries measure trends in HIV incidence to assess the impact of HIV prevention and treatment programmes. Most countries have approximated trends in HIV incidence through modelled estimates or through trends in HIV prevalence among young people (aged 15–24 years) assuming they have recently become sexually active and have thus only been recently exposed to HIV.</p>
</sec>
<sec><title>Methods</title>
<p>Trends in HIV incidence are described and results are compared using three proxy measures of incidence: HIV prevalence among young women attending antenatal clinics (ANCs) in 22 countries; HIV prevalence among young male and female nationally representative household survey respondents in 14 countries; and modelled estimates of adult (ages 15–49 years) HIV incidence in 26 countries. The significance of changes in prevalence among ANC attendees and young survey respondents is tested.</p>
</sec>
<sec><title>Results</title>
<p>Among 26 countries, 25 had evidence of some decline in HIV incidence and 15 showed statistically significant declines in either ANC data or survey data. Only in Mozambique did the direction of the trend in young ANC attendees differ from modelled adult incidence, and in Mali and Zambia trends among young men differed from trends in adult incidence. The magnitude of change differed by method.</p>
</sec>
<sec><title>Conclusions</title>
<p>Trends in HIV prevalence among young people show encouraging declines. Changes in fertility patterns, HIV-infected children surviving to adulthood, and participation bias could affect future proxy measures of incidence trends.</p>
</sec>
</abstract>
<kwd-group><kwd>AFRICA</kwd>
<kwd>HIV</kwd>
<kwd>SURVEILLANCE</kwd>
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<name type="personal"><namePart type="given">Jesus Maria</namePart>
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<abstract>Background Countries measure trends in HIV incidence to assess the impact of HIV prevention and treatment programmes. Most countries have approximated trends in HIV incidence through modelled estimates or through trends in HIV prevalence among young people (aged 15–24 years) assuming they have recently become sexually active and have thus only been recently exposed to HIV. Methods Trends in HIV incidence are described and results are compared using three proxy measures of incidence: HIV prevalence among young women attending antenatal clinics (ANCs) in 22 countries; HIV prevalence among young male and female nationally representative household survey respondents in 14 countries; and modelled estimates of adult (ages 15–49 years) HIV incidence in 26 countries. The significance of changes in prevalence among ANC attendees and young survey respondents is tested. Results Among 26 countries, 25 had evidence of some decline in HIV incidence and 15 showed statistically significant declines in either ANC data or survey data. Only in Mozambique did the direction of the trend in young ANC attendees differ from modelled adult incidence, and in Mali and Zambia trends among young men differed from trends in adult incidence. The magnitude of change differed by method. Conclusions Trends in HIV prevalence among young people show encouraging declines. Changes in fertility patterns, HIV-infected children surviving to adulthood, and participation bias could affect future proxy measures of incidence trends.</abstract>
<note type="footnotes">UNAIDS Report 2012 Guest Editors</note>
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Trends in HIV prevalence among young people in generalised epidemics: implications for monitoring the HIV epidemic

Trends in HIV prevalence among young people in generalised epidemics: implications for monitoring the HIV epidemic

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