Country-specific estimates and models of HIV and AIDS: methods and limitations

Schwartländer, Bernhard; Stanecki, Karen; Brown, Tim; Way, Peter O.; Monasch, Roeland; Chin, James; Tarantola, Daniel; Walker, Neff

doi:10.1097/00002030-199912030-00017

Cited by 70 publications

(37 citation statements)

References 16 publications

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“…Apart from the demand of and access to healthcare services being often associated with several factors of HIV infection risk, this can reduce fertility and, thus, underestimate the prevalence of the infection, especially among women at 30 years of age or older. 9,10,16 On the other hand, the association of the demand for prenatal care with high risk of infection could be minimized in areas with low HIV infection prevalence and high test coverage, something which would reduce the effect of selection bias.…”

Section: Resultsmentioning

confidence: 99%

Infecção pelo HIV entre gestantes atendidas nos centros de testagem e aconselhamento em Aids

et al. 2007

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OBJECTIVE:To estimate HIV prevalence and identify high-risk sexual behavior for infection in pregnant women who were given prenatal assistance. METHODS:Cross-sectional study based on attendance records of 8,002 pregnant women (25% of all municipalities) who lived in 27 municipalities in Southern Brazil in 2003 and had anti-HIV tests done in a testing and counseling center that performed prenatal assistance. Sociodemographic and behavioral data were gathered, as well as syphilis and HIV test results, during the individual counseling sessions registered in the data bank of the Sistema de Informações dos Centros de Testagem e Aconselhamento (Information System on Testing and Counseling Centers). Women who sought the centers for confi rmation of previous serology or were referred to this service due to the presence of AIDS symptoms were excluded from the data base. RESULTS:A total of 0.5% of all the pregnant women analyzed (CI 95%=0.3;0.6) were HIV positive. The only variable associated with HIV seropositivity was schooling. The majority of them were basically exposed through unprotected sexual intercourse with the only partner they had a steady relationship with. Younger pregnant women who were single, unemployed and had lower level of education constituted the group with highest exposure. CONCLUSIONS: The Sistema de Informações dos Centros de Testagem eAconselhamento turned out to be useful for the epidemiological surveillance of HIV infection and high-risk behavior among pregnant women and could also be useful as regards other populations.

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Section: Resultsmentioning

confidence: 99%

Infecção pelo HIV entre gestantes atendidas nos centros de testagem e aconselhamento em Aids

et al. 2007

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“…These figures for prevalence levels were derived using an epidemiological model (EPIMODEL, Chin and Lwanga, 1991); the key data used to calibrate the model for each country include: point prevalence estimates for 1994 and 1997; the year 'extensive spread' of infection started; the most likely shapes of the country specific epidemiological curves for the HIV prevalence over time; progression rates and age structure of the HIV-infected population. The method used and its strengths and weaknesses are discussed extensively in Schwartlander et al, (1999Schwartlander et al, ( , pp 2455Schwartlander et al, ( -2457. The HIV prevalence rates have been a subject of considerable recent research and are increasingly based on robust epidemiological data, e.g., blood samples taken at ante-natal clinics; indeed the "HIV sentinel surveillance systems are generally rather extensive when compared with surveillance systems for other communicable diseases" (Swartlander et al, 1999(Swartlander et al, , p 2455.…”

Section: About Herementioning

confidence: 99%

AIDS and economic growth: A human capital approach

McDonald

Roberts

2006

Journal of Development Economics

100

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It is estimated that by 2001 20 million people had died from AIDS, which is now the world's fourth biggest cause of death. While the highest prevalence and death rates and number of infected persons are reported for sub-Saharan Africa, where life expectancies at birth are declining rapidly and infant mortality rates are increasing, there is evidence that the epidemic is accelerating in Asia and Eastern Europe. While the human and social costs of the HIV/AIDS epidemic are the major causes for concern, the econometric results reported in this paper indicate that the macroeconomic affects of the HIV/AIDS epidemic have been substantial; especially in Africa where the average marginal negative impact on income per capita of a one percent increase in HIV prevalence rate is 0.59 percent. Even in countries where the HIV prevalence rates are lower the marginal impacts are non trivial.

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“…In the 1990s the World Health Organization’s Global AIDS Programme developed initial modelling methods and tools [15] and published global, regional and the first set of country estimates of the number of people living with HIV [16]. These and subsequent sets of estimates published by UNAIDS starting in the late 1990s were generated by a small group of individuals based in Geneva, Switzerland, using the available epidemiological data on the HIV epidemic [16,17]. While these estimates were the best available at the time, they were based on small studies which were not representative of the geographic area or populations to which the data were extrapolated.…”

Section: Resultsmentioning

confidence: 99%

Producing HIV estimates: from global advocacy to country planning and impact measurement

Mahy

Brown

Stover

et al. 2017

Global Health Action

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Background: The development of global HIV estimates has been critical for understanding, advocating for and funding the HIV response. The process of generating HIV estimates has been cited as the gold standard for public health estimates. Objective: This paper provides important lessons from an international scientific collaboration and provides a useful model for those producing public health estimates in other fields. Design: Through the compilation and review of published journal articles, United Nations reports, other documents and personal experience we compiled historical information about the estimates and identified potential lessons for other public health estimation efforts. Results: Through the development of core partnerships with country teams, implementers, demographers, mathematicians, epidemiologists and international organizations, UNAIDS has led a process to develop the capacity of country teams to produce internationally comparable HIV estimates. The guidance provided by these experts has led to refinements in the estimated numbers of people living with HIV, new HIV infections and AIDS-related deaths over the past 20 years.A number of important updates to the methods since 1997 resulted in fluctuations in the estimated levels, trends and impact of HIV. The largest correction occurred between the 2005 and 2007 rounds with the additions of household survey data into the models. In 2001 the UNAIDS models at that time estimated there were 40 million people living with HIV. In 2016, improved models estimate there were 30 million (27.6–32.7 million) people living with HIV in 2001. Conclusions: Country ownership of the estimation tools has allowed for additional uses of the results than had the results been produced by researchers or a team in Geneva. Guidance from a reference group and input from country teams have led to critical improvements in the models over time. Those changes have improved countries’ and stakeholders’ understanding of the HIV epidemic.

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Country-specific estimates and models of HIV and AIDS: methods and limitations

Cited by 70 publications

References 16 publications

Infecção pelo HIV entre gestantes atendidas nos centros de testagem e aconselhamento em Aids

Infecção pelo HIV entre gestantes atendidas nos centros de testagem e aconselhamento em Aids

AIDS and economic growth: A human capital approach

Producing HIV estimates: from global advocacy to country planning and impact measurement

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