ArticleAIDS (London, England)2019
Estimating and projecting the number of new HIV diagnoses and incidence in Spectrum's case surveillance and vital registration tool.
Article in AIDS (London, England), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.
- A systematic review of models used to estimate undiagnosed HIV prevalence in high-income low-prevalence countries and territories.AIDS (London, England) · 2026Pooled it
- Updates to Spectrum's case surveillance and vital registration tool for HIV estimates and projections.Journal of the International AIDS Society · 2021Article
- Updates to the Spectrum/AIM model for the UNAIDS 2020 HIV estimates.Journal of the International AIDS Society · 2021Article
- Disease progression and mortality with untreated HIV infection: evidence synthesis of HIV seroconverter cohorts, antiretroviral treatment clinical cohorts and population-based survey data.Journal of the International AIDS Society · 2021Article
- Modelling of HIV prevention and treatment progress in five South African metropolitan districts.Scientific reports · 2021Article
- Monitoring progress towards the first UNAIDS 90-90-90 target in key populations living with HIV in Norway.BMC infectious diseases · 2020Article
- HIV estimates through 2018: data for decision-making.AIDS (London, England) · 2019Article
- Updates to the Spectrum/AIM model for estimating key HIV indicators at national and subnational levels.AIDS (London, England) · 2019Review
- The Estimation and Projection Package Age-Sex Model and the r-hybrid model: new tools for estimating HIV incidence trends in sub-Saharan Africa.AIDS (London, England) · 2019Article
- Summarizing the results and methods of the 2019 Joint United Nations Programme on HIV/AIDS HIV estimates.AIDS (London, England) · 2019Article
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Authors and funding
4 authors at 3 institutions in 3 countries.
Funding
Abstract
objectiveThe Joint United Nations Programme on HIV/AIDS-supported Spectrum software package is used by most countries worldwide to monitor the HIV epidemic. In Spectrum, HIV incidence trends among adults (aged 15-49 years) are derived by either fitting to seroprevalence surveillance and survey data or generating curves consistent with case surveillance and vital registration data, such as historical trends in the number of newly diagnosed infections or AIDS-related deaths. This article describes development and application of the case surveillance and vital registration (CSAVR) tool for the 2019 estimate round.
methodsIncidence in CSAVR is either estimated directly using single logistic, double logistic, or spline functions, or indirectly via the 'r-logistic' model, which represents the (log-transformed) per-capita transmission rate using a logistic function. The propensity to get diagnosed is assumed to be monotonic, following a Gamma cumulative distribution function and proportional to mortality as a function of time since infection. Model parameters are estimated from a combination of historical surveillance data on newly reported HIV cases, mean CD4 at HIV diagnosis and estimates of AIDS-related deaths from vital registration systems. Bayesian calibration is used to identify the best fitting incidence trend and uncertainty bounds.
resultsWe used CSAVR to estimate HIV incidence, number of new diagnoses, mean CD4 at diagnosis and the proportion undiagnosed in 31 European, Latin American, Middle Eastern, and Asian-Pacific countries. The spline model appeared to provide the best fit in most countries (45%), followed by the r-logistic (25%), double logistic (25%), and single logistic models. The proportion of HIV-positive people who knew their status increased from about 0.31 [interquartile range (IQR): 0.10-0.45] in 1990 to about 0.77 (IQR: 0.50-0.89) in 2017. The mean CD4 at diagnosis appeared to be stable, at around 410 cells/μl (IQR: 224-567) in 1990 and 373 cells/μl (IQR: 174-475) by 2017.
conclusionRobust case surveillance and vital registration data are routinely available in many middle-income and high-income countries while HIV seroprevalence surveillance and survey data may be scarce. In these countries, CSAVR offers a simpler, improved approach to estimating and projecting trends in both HIV incidence and knowledge of HIV status.
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