Evidence map›Paper›PMID 27863998›Full record

ArticleThe lancet. HIV2017

Swaziland HIV Incidence Measurement Survey (SHIMS): a prospective national cohort study.

Jessica Justman, Jason B Reed, George Bicego, Deborah Donnell, Keala Li, Naomi Bock, Alison Koler, Neena M Philip, Charmaine K Mlambo, Bharat S Parekh and 4 more

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The lancet. HIV, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 60 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
60citing papers in PubMed, 4 pooled it
8.0field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

60 citing papers in PubMed, 4 syntheses or guidelines pooled it, 90 citations in OpenAlex.

  1. A Review of Network Models for HIV Spread.Journal of acquired immune deficiency syndromes (1999) · 2025
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  15. Exploring the experiences of school-going children with HIV in Eswatini: A qualitative inquiry.African journal of primary health care & family medicine · 2024
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  20. How Can Progress Toward Ending the Human Immunodeficiency Virus Epidemic in the United States Be Monitored?Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors at 7 institutions in 2 countries.

Jessica JustmanICAP at Columbia University, Mailman School of Public Health, Columbia University, New York, NY, USA. Electronic address: jj2158@columbia.edu.
Jason B ReedJhpiego, Washington, DC, USA.
George BicegoUS Centers for Disease Control and Prevention, Center for Global Health, Division of Global HIV/AIDS, Atlanta, GA, USA.
Deborah DonnellFred Hutchinson Cancer Research Center, Seattle, WA, USA.
Keala LiFred Hutchinson Cancer Research Center, Seattle, WA, USA.
Naomi BockUS Centers for Disease Control and Prevention, Center for Global Health, Division of Global HIV/AIDS, Atlanta, GA, USA.
Alison KolerPact, Dar es Salaam, Tanzania.
Neena M PhilipICAP at Columbia University, Mailman School of Public Health, Columbia University, New York, NY, USA.
Charmaine K MlamboClinton Health Access Initiative, Mbabane, Swaziland.
Bharat S ParekhUS Centers for Disease Control and Prevention, Center for Global Health, Division of Global HIV/AIDS, Atlanta, GA, USA.
Yen T DuongICAP at Columbia University, Mailman School of Public Health, Columbia University, New York, NY, USA.
Dennis L EllenbergerUS Centers for Disease Control and Prevention, Center for Global Health, Division of Global HIV/AIDS, Atlanta, GA, USA.
Wafaa M El-SadrICAP at Columbia University, Mailman School of Public Health, Columbia University, New York, NY, USA.
Rejoice NkambuleMinistry of Health-Swaziland, Mbabane, Swaziland.
Columbia University · USCenter for Global Health · USFred Hutch Cancer Center · USCenters for Disease Control and Prevention · USClinton Health Access Initiative · USDaiichi Sankyo (United States) · USMinistry of Health · SZ

Funding

Intramural CDC HHS CC999999
6 · The paper itself

Abstract

backgroundSwaziland has the highest national HIV prevalence worldwide. The Swaziland HIV Incidence Measurement Survey (SHIMS) provides the first national HIV incidence estimate based on prospectively observed HIV seroconversions.

methodsA two-stage survey sampling design was used to select a nationally representative sample of men and women aged 18-49 years from 14 891 households in 575 enumeration areas in Swaziland, who underwent household-based counselling and rapid HIV testing during 2011. All individuals aged 18-49 years who resided or had slept in the household the night before and were willing to undergo home-based HIV testing, answer demographic and behavioural questions in English or siSwati, and provide written informed consent were eligible for the study. We performed rapid HIV testing and assessed sociodemographic and behavioural characteristics with use of a questionnaire at baseline and, for HIV-seronegative individuals, 6 months later. We calculated HIV incidence with Poisson regression modelling as events per person-years × 100, and we assessed covariables as predictors with Cox proportional hazards modelling. Survey weighting was applied and all models used survey sampling methods.

findingsBetween Dec 10, 2010, and June 25, 2011, 11 897 HIV-seronegative adults were enrolled in SHIMS and 11 232 (94%) were re-tested. Of these, 145 HIV seroconversions were observed, resulting in a weighted HIV incidence of 2·4% (95% CI 2·1-2·8). Incidence was nearly twice as high in women (3·1%; 95% CI 2·6-3·7) as in men (1·7%; 1·3-2·1, p<0·0001). Among men, partner's HIV-positive status (adjusted hazard ratio [aHR] 2·67, 1·06-6·82, p=0·040) or unknown serostatus (aHR 4·64, 2·32-9·27, p<0·0001) in the past 6 months predicted HIV seroconversion. Among women, significant predictors included not being married (aHR 2·90, 1·44-5·84, p=0·0030), having a spouse who lives elsewhere (aHR 2·66, 1·29-5·45, p=0·0078), and having a partner in the past 6 months with unknown HIV status (aHR 2·87, 1·44-5·84, p=0·0030).

interpretationSwaziland has the highest national HIV incidence in the world. In high-prevalence countries, population-based incidence measures and programmes that further expand HIV testing and support disclosure of HIV status are needed.

fundingPresident's Emergency Plan for AIDS Relief (PEPFAR) by the Centers for Disease Control and Prevention.

Indexed as

HIV-1AdolescentAdultCounselingEswatiniFamily CharacteristicsFemaleHIV InfectionsHumansIncidenceMaleMass ScreeningMiddle AgedPrevalenceProportional Hazards ModelsProspective Studies

Identifiers

PMID27863998
PMCPMC5291824
OpenAlexW2550098977

What OpenQuestion holds

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LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.