Observational studyThe lancet. HIV2021
Age patterns of HIV incidence in eastern and southern Africa: a modelling analysis of observational population-based cohort studies.
Observational study in The lancet. HIV, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 54 papers.
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.
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.
Who cites it
54 citing papers in PubMed, 88 citations in OpenAlex.
- MVA.HIVconsvX vaccination-evoked T cell expansion inversely associates with age in people with HIV-1 on antiretroviral therapy.The Journal of clinical investigation · 2026Trial
- HIV Social-network intervention more effective in older populations in Kenya.BMC public health · 2024Trial
- Facility characteristics preferred by older men seeking medical male circumcision services in Kenya: qualitative findings from the 'Tasco' study (May 2014-June 2016).BMC public health · 2024Trial
- Maternal and Perinatal Outcomes Associated with Maternal HIV Infection in a Tertiary Hospital in Eastern Cape Province, South Africa.Infectious disease reports · 2026Article
- Evaluating the biomedical and behavioral drivers of HIV incidence decline in adolescent girls and young women in Uganda: A mathematical modeling study.PLoS medicine · 2026Article
- Appraising the HIV prevention cascade methodology to improve HIV prevention targets: Lessons learned from a general population pilot study in east Zimbabwe.PLOS global public health · 2026Article
- Knowledge of HIV status in a rural Ugandan population with a sustained, generalised HIV epidemic.PLOS global public health · 2026Article
- Barriers to and Facilitators of Heterosexual Men's Engagement with the PrEP Care Continuum in Sub-Saharan Africa: A Scoping Review.AIDS and behavior · 2026Article
- Assessment of serum cobalamin (vitamin B12) status among Human Immunodeficiency Virus (HIV) infected Nigerians with anaemia using serum methylmalonic acid.African health sciences · 2025Article
- Development and validation of a risk prediction model for pulmonary tuberculosis in presumptive tuberculosis patients in Tigray, northern Ethiopia.Scientific reports · 2025Article
- Socio-demographic and geographic disparities in HIV prevalence, HIV testing and treatment coverage: An analysis of 108 national household surveys in 33 African countries.Journal of the International AIDS Society · 2025Article
- Temporal analysis of non-communicable diseases and NCD-HIV/AIDS comorbidity in Malawi: A 4-year retrospective study 2020-2022.Tropical medicine & international health : TM & IH · 2025Article
- Intention to Use Pre-Exposure Prophylaxis Among Age Groups of Brazilian Men Who Have Sex With Men: National Cross-Sectional Study.JMIR public health and surveillance · 2025Article
- Trends in HIV-related knowledge, behaviors and determinants of HIV testing among adolescent women aged 15-24 in Nigeria.Tropical medicine and health · 2025Article
- Method for modelling the number of HIV and AIDS cases using least square spline Biresponse nonparametric negative binomial regression.MethodsX · 2025Article
- The changing cost-effectiveness of primary HIV prevention: simple calculations of direct effects.Journal of the International AIDS Society · 2025Article
- Preventing HIV in women in Africa.Nature medicine · 2025Review
- The prevalence, incidence, and sociodemographic risk factors of HIV among older adults in sub-Saharan Africa (AWI-Gen): a multicentre, longitudinal cohort study.The lancet. Healthy longevity · 2025Article
- Measurement and interpretation of the Harare HIV combination prevention cascade in priority populations: A population survey of adolescent girls and young women and young men in Zimbabwe.medRxiv : the preprint server for health sciences · 2025Article
- The clinical and chest radiographic features of respiratory syncytial virus-associated severe respiratory illness in hospitalised adults in South Africa, 2022 - 2023.African journal of thoracic and critical care medicine · 2025Article
Corrections and comments
- Commented on by
- Commented on by
Authors and funding
25 authors at 10 institutions in 7 countries.
Funding
Abstract
backgroundAs the HIV epidemic in sub-Saharan Africa matures, evidence about the age distribution of new HIV infections and how this distribution has changed over the epidemic is needed to guide HIV prevention. We aimed to assess trends in age-specific HIV incidence in six population-based cohort studies in eastern and southern Africa, reporting changes in mean age at infection, age distribution of new infections, and birth cohort cumulative incidence.
methodsWe used a Bayesian model to reconstruct age-specific HIV incidence from repeated observations of individuals' HIV serostatus and survival collected among population HIV cohorts in rural Malawi, South Africa, Tanzania, Uganda, and Zimbabwe, in a collaborative analysis of the ALPHA network. We modelled HIV incidence rates by age, time, and sex using smoothing splines functions. We estimated incidence trends separately by sex and study. We used estimated incidence and prevalence results for 2000-17, standardised to study population distribution, to estimate mean age at infection and proportion of new infections by age. We also estimated cumulative incidence (lifetime risk of infection) by birth cohort.
findingsAge-specific incidence declined at all ages, although the timing and pattern of decline varied by study. The mean age at infection was higher in men (cohort mean 27·8-34·6 years) than in women (24·8-29·6 years). Between 2000 and 2017, the mean age at infection per cohort increased slightly: 0·5 to 2·8 years among men and -0·2 to 2·5 years among women. Across studies, between 38% and 63% (cohort medians) of the infections in women were among those aged 15-24 years and between 30% and 63% of infections in men were in those aged 20-29 years. Lifetime risk of HIV declined for successive birth cohorts.
interpretationHIV incidence declined in all age groups and shifted slightly to older ages. Disproportionate new HIV infections occur among women aged 15-24 years and men aged 20-29 years, supporting focused prevention in these groups. However, 40-60% of infections were outside these ages, emphasising the importance of providing appropriate HIV prevention to adults of all ages.
fundingBill & Melinda Gates Foundation.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.