ArticleThe lancet. HIV2021
Trends in knowledge of HIV status and efficiency of HIV testing services in sub-Saharan Africa, 2000-20: a modelling study using survey and HIV testing programme data.
Article in The lancet. HIV, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06133686 (Implementing Oral), which is not on this map. Cited by 95 papers, 5 of them syntheses that pooled it.
What it found
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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.
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.
Implementing Oral (Event-driven and Daily) and Long-acting Pre-Exposure Prophylaxis in Mobile Men in Sub-Saharan Africa: a Phase 3b, Open-label, Hybrid Type 2 Implementation and Effectiveness Trial
Who cites it
95 citing papers in PubMed, 5 syntheses or guidelines pooled it, 163 citations in OpenAlex.
- Simulation modeling for the design and evaluation of HIV drug resistance interventions: a systematic review of literature.BMC public health · 2026Pooled it
- Trends in HIV testing, the treatment cascade, and HIV incidence among men who have sex with men in Africa: a systematic review and meta-analysis.The lancet. HIV · 2023Pooled it
- Regional and country-level trends in cervical cancer screening coverage in sub-Saharan Africa: A systematic analysis of population-based surveys (2000-2020).PLoS medicine · 2023Pooled it
- Men missing from the HIV care continuum in sub-Saharan Africa: a meta-analysis and meta-synthesis.Journal of the International AIDS Society · 2022Pooled it
- Population sizes, HIV prevalence, and HIV prevention among men who paid for sex in sub-Saharan Africa (2000-2020): A meta-analysis of 87 population-based surveys.PLoS medicine · 2022Pooled it
- Uptake of community-based integrated HIV and sexual and reproductive health services for young people in Zimbabwe: the CHIEDZA study.BMC health services research · 2025Trial
- "There is no need to leave the beach to test": a qualitative study of HIV self-testing knowledge and acceptability of HIV self-test kit distribution among social networks of fishermen in Western Kenya.BMC public health · 2025Trial
- Did you hear about HIV self-testing? HIV self-testing awareness after community-based HIVST distribution in rural Zimbabwe.BMC infectious diseases · 2022Trial
- Have We Met Before? Findings on HIV Retesting in Routine Healthcare Settings, Using Eswatini HIV-1 Recent Infection Surveillance Data.Journal of the International AIDS Society · 2026Article
- Article
- Unawareness of HIV-Positive Status among Men in Seven Sub-Saharan African Countries: Age, Behavioral, and Structural Determinants.AIDS and behavior · 2026Article
- HIV self-testing and its associated factors among nursing and medical university students: A cross-sectional study in EasternUganda.BMC infectious diseases · 2026Article
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- From HIV testing to ART initiation under fire: joinpoint regression analysis of regional disparities during the full-scale war against Ukraine.Conflict and health · 2026Article
- A cross-sectional survey of men's attitudes towards public health services and their utilisation practices in Limpopo Province, South Africa.South African family practice : official journal of the South African Academy of Family Practice/Primary Care · 2026Article
- Trends in HIV self-testing uptake in Africa: A modeling study of population-based surveys and HIV testing program data.PLoS medicine · 2026Article
- Scaling Up HIV Self-Testing in Africa: Insights From National Programmatic Data in Eight Countries.Journal of the International AIDS Society · 2026Article
- Gaps in Effective HIV Pre-exposure Prophylaxis Screening and Uptake Among Fishermen in Kenya.AIDS and behavior · 2026Article
- Factors associated with unawareness of HIV-positive status among individuals aged ≥ 15 years in Tanzania: Evidence from the Tanzania HIV Impact Survey 2022-2023.BMC public health · 2026Article
35 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
12 authors at 8 institutions in 7 countries.
Funding
Abstract
backgroundMonitoring knowledge of HIV status among people living with HIV is essential for an effective national HIV response. This study estimates progress and gaps in reaching the UNAIDS 2020 target of 90% knowledge of status, and the efficiency of HIV testing services in sub-Saharan Africa, where two thirds of all people living with HIV reside.
methodsFor this modelling study, we used data from 183 population-based surveys (including more than 2·7 million participants) and national HIV testing programme reports (315 country-years) from 40 countries in sub-Saharan Africa as inputs into a mathematical model to examine trends in knowledge of status among people living with HIV, median time from HIV infection to diagnosis, HIV testing positivity, and proportion of new diagnoses among all positive tests, adjusting for retesting. We included data from 2000 to 2019, and projected results to 2020.
findingsAcross sub-Saharan Africa, knowledge of status steadily increased from 5·7% (95% credible interval [CrI] 4·6-7·0) in 2000 to 84% (82-86) in 2020. 12 countries and one region, southern Africa, reached the 90% target. In 2020, knowledge of status was lower among men (79%, 95% CrI 76-81) than women (87%, 85-89) across sub-Saharan Africa. People living with HIV aged 15-24 years were the least likely to know their status (65%, 62-69), but the largest gap in terms of absolute numbers was among men aged 35-49 years, with 701 000 (95% CrI 611 000-788 000) remaining undiagnosed. As knowledge of status increased from 2000 to 2020, the median time to diagnosis decreased from 9·6 years (9·1-10) to 2·6 years (1·8-3·5), HIV testing positivity declined from 9·0% (7·7-10) to 2·8% (2·1-3·9), and the proportion of first-time diagnoses among all positive tests dropped from 89% (77-96) to 42% (30-55).
interpretationOn the path towards the next UNAIDS target of 95% diagnostic coverage by 2025, and in a context of declining positivity and yield of first-time diagnoses, disparities in knowledge of status must be addressed. Increasing knowledge of status and treatment coverage among older men could be crucial to reducing HIV incidence among women in sub-Saharan Africa, and by extension, reducing mother-to-child transmission.
fundingSteinberg Fund for Interdisciplinary Global Health Research (McGill University); Canadian Institutes of Health Research; Bill & Melinda Gates Foundation; Fonds the recherche du Québec-Santé; UNAIDS; UK Medical Research Council; MRC Centre for Global Infectious Disease Analysis; UK Foreign, Commonwealth & Development Office.
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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.