ArticleJournal of the International AIDS Society2021
Naomi: a new modelling tool for estimating HIV epidemic indicators at the district level in sub-Saharan Africa.
Article in Journal of the International AIDS Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers.
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Who cites it
36 citing papers in PubMed.
- Visualizing stigma and HIV service engagement: a participatory approach using causal loop diagrams.BMC public health · 2026Article
- Drivers of Vertical HIV Transmission in Sub-Saharan Africa and the Impact and Cost-Effectiveness of Targeted and Universal Lenacapavir Pre-Exposure Prophylaxis.Journal of the International AIDS Society · 2026Article
- Incidence of Cancers Among Children Living With HIV in Malawi After Widespread Availability of Antiretroviral Therapy: A Population-Based Study.JCO global oncology · 2026Article
- Fast approximate Bayesian inference of HIV indicators using PCA adaptive Gauss-Hermite quadrature.Journal of theoretical biology · 2026Article
- Epidemiology of Pediatric Tuberculosis in the Western Cape: A Population-Based Study (2017-2023).Pediatrics · 2026Article
- Age, sex-and what else? Rethinking priorities to close gaps in the HIV care cascade.Journal of the International AIDS Society · 2026Article
- HIV incidence and prevalence among adults in Mozambique: estimates from the Population-based HIV Impact Assessment Survey (INSIDA 2021) and district-level modelling.Journal of the International AIDS Society · 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
- VITALdb: to select the best viroinformatics tools for a desired virus or application.Briefings in bioinformatics · 2025Article
- Geospatial and phylogenetic clustering of acute and recent HIV infections in Lilongwe, Malawi.PLOS global public health · 2025Article
- The influence of social networks in adoption of integrated health interventions: A qualitative study of fishermen in Malawi.PLOS global public health · 2025Article
- High-resolution spatio-temporal risk mapping for malaria in Namibia: a comprehensive analysis.Malaria journal · 2024Article
- Population size, HIV prevalence, and antiretroviral therapy coverage among key populations in sub-Saharan Africa: collation and synthesis of survey data, 2010-23.The Lancet. Global health · 2024Article
- A sub-national HIV epidemic appraisal in Kenya: a new approach for identifying priority geographies, populations and programmes for optimizing coverage for HIV prevention.Journal of the International AIDS Society · 2024Article
- Attrition Rates in HIV Viral Load Monitoring and Factors Associated With Overdue Testing Among Children Within South Africa's Antiretroviral Treatment Program: Retrospective Descriptive Analysis.JMIR public health and surveillance · 2024Article
- Substantial but spatially heterogeneous progress in male circumcision for HIV prevention in South Africa.Communications medicine · 2024Article
- Comparison of Empirically Derived and Model-Based Estimates of Key Population HIV Incidence and the Distribution of New Infections by Population Group in Sub-Saharan Africa.Journal of acquired immune deficiency syndromes (1999) · 2024Article
- Updated Data and Methods for the 2023 UNAIDS HIV Estimates.Journal of acquired immune deficiency syndromes (1999) · 2024Article
- Improved Indicators for Subnational Unmet Antiretroviral Therapy Need in the Health System: Updates to the Naomi Model in 2023.Journal of acquired immune deficiency syndromes (1999) · 2024Article
- Triangulation of Routine Antenatal HIV Prevalence Data and Adjusted HIV Estimates in Mozambique.Journal of acquired immune deficiency syndromes (1999) · 2024Article
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Abstract
introductionHIV planning requires granular estimates for the number of people living with HIV (PLHIV), antiretroviral treatment (ART) coverage and unmet need, and new HIV infections by district, or equivalent subnational administrative level. We developed a Bayesian small-area estimation model, called Naomi, to estimate these quantities stratified by subnational administrative units, sex, and five-year age groups.
methodsSmall-area regressions for HIV prevalence, ART coverage and HIV incidence were jointly calibrated using subnational household survey data on all three indicators, routine antenatal service delivery data on HIV prevalence and ART coverage among pregnant women, and service delivery data on the number of PLHIV receiving ART. Incidence was modelled by district-level HIV prevalence and ART coverage. Model outputs of counts and rates for each indicator were aggregated to multiple geographic and demographic stratifications of interest. The model was estimated in an empirical Bayes framework, furnishing probabilistic uncertainty ranges for all output indicators. Example results were presented using data from Malawi during 2016-2018.
resultsAdult HIV prevalence in September 2018 ranged from 3.2% to 17.1% across Malawi's districts and was higher in southern districts and in metropolitan areas. ART coverage was more homogenous, ranging from 75% to 82%. The largest number of PLHIV was among ages 35 to 39 for both women and men, while the most untreated PLHIV were among ages 25 to 29 for women and 30 to 34 for men. Relative uncertainty was larger for the untreated PLHIV than the number on ART or total PLHIV. Among clients receiving ART at facilities in Lilongwe city, an estimated 71% (95% CI, 61% to 79%) resided in Lilongwe city, 20% (14% to 27%) in Lilongwe district outside the metropolis, and 9% (6% to 12%) in neighbouring Dowa district. Thirty-eight percent (26% to 50%) of Lilongwe rural residents and 39% (27% to 50%) of Dowa residents received treatment at facilities in Lilongwe city.
conclusionsThe Naomi model synthesizes multiple subnational data sources to furnish estimates of key indicators for HIV programme planning, resource allocation, and target setting. Further model development to meet evolving HIV policy priorities and programme need should be accompanied by continued strengthening and understanding of routine health system data.
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