1. Updates to Spectrum's case surveillance and vital registration tool for HIV estimates and projections
- Author
-
Mahiane, Severin G., Eaton, Jeffrey W., Glaubius, Robert, Case, Kelsey K., Sabin, Keith M., and Marsh, Kimberly
- Subjects
Sentinel health events -- Methods ,Diseases -- Reporting ,Mathematical software -- Usage ,HIV infection -- Forecasts and trends -- Models ,Statistical/mathematical software ,Company business planning ,Market trend/market analysis ,Health ,UNAIDS -- Planning -- Equipment and supplies - Abstract
Introduction: The Case Surveillance and Vital Registration (CSAVR) model within Spectrum estimates HIV incidence trends from surveillance data on numbers of new HIV diagnoses and HIV-related deaths. This article describes developments of the CSAVR tool to more flexibly model diagnosis rates over time, estimate incidence patterns by sex and age group and by key population group. Methods: We modelled HIV diagnosis rate trends as a mixture of three factors, including temporal and opportunistic infection components. The tool was expanded to estimate incidence rate ratios by sex and age for countries with disaggregated reporting of new HIV diagnoses and AIDS deaths, and to account for information on key populations such as men who have sex with men (MSM), males who inject drugs (MWID), female sex workers (FSW) and females who inject drugs (FWID). We used a Bayesian framework to calibrate the tool in 71 high-income or low-HIV burden countries. Results: Across countries, an estimated median 89% (interquartile range [IQR]: 7896-9696) of HIV-positive adults knew their status in 2019. Mean CD4 counts at diagnosis were stable over time, with a median of 456 cell/[micro]l (IQR: 391-508) across countries in 2019. In European countries reporting new HIV diagnoses among key populations, median estimated proportions of males that are MSM and MWID was 1.3% (IQR: 0.996-2.0%) and 0.5696 (IQR: 0.5196-0.6496), respectively. The median estimated proportions of females that are FSW and FWID were 0.3696 (IQR: 0.2796-0.4596) and 0.14 (IQR: 0.1396-0.1596), respectively. HIV incidence per 100 person-years increased among MSM, with median estimates reaching 0.43 (IQR: 0.29-1.73) in 2019, but remained stable in MWID, FSW and FWID, at around 0.12 (IQR: 0.04-1.9), 0.09 (IQR: 0.06-0.69) and 0.1396 (IQR: 0.0896-0.9196) in 2019, respectively. Knowledge of HIV status among HIV-positive adults gradually increased since the early 1990s to exceed 7596 in more than 7596 of countries in 2019 among each key population. Conclusions: CSAVR offers an approach to using routine surveillance and vital registration data to estimate and project trends in both HIV incidence and knowledge of HIV status. Keywords: HIV case-based surveillance; HIV incidence; HIV-related mortality; key population; knowledge of status; statistical models, 1 | INTRODUCTION The Joint United Nations Programme on HIV/AIDS (UNAIDS)-supported Spectrum software package is used by most countries in the world to generate annual estimates of HIV burden and [...]
- Published
- 2021
- Full Text
- View/download PDF