Mary Mahy1, Martina Penazzato, Andrea Ciaranello, Lynne Mofenson, Constantin T Yianoutsos, Mary-Ann Davies, John Stover. 1. aJoint UN Programme on HIV/AIDSbHIV Department, World Health Organization, Geneva, SwitzerlandcMassachusetts General Hospital, Boston, MassachusettsdElizabeth Glaser Pediatric AIDS Foundation, Washington, District of ColumbiaeIndiana University, Indianapolis, Indiana, USAfUniversity of Cape Town, Cape Town, South AfricagAvenir Health, Glastonbury, Connecticut, USA.
Abstract
OBJECTIVE: Estimated numbers of children living with HIV determine programmatic and treatment needs. We explain the changes made to the UNAIDS estimates between 2015 and 2016, and describe the challenges around these estimates. METHODS: Estimates of children newly infected, living with HIV, and dying of AIDS are developed by country teams using Spectrum software. Spectrum files are available for 160 countries, which represent 98% of the global population. In 2016, the methods were updated to reflect the latest evidence on mother-to-child HIV transmission and improved assumptions on the age children initiate antiretroviral therapy. We report updated results using the 2016 model and validate these estimates against mother-to-child transmission rates and HIV prevalence from population-based surveys for the survey year. RESULTS: The revised 2016 model estimates 27% fewer children living with HIV in 2014 than the 2015 model, primarily due to changes in the probability of mother-to-child transmission among women with incident HIV during pregnancy. The revised estimates were consistent with population-based surveys of HIV transmission and HIV prevalence among children aged 5-9 years, but were lower than surveys among children aged 10-14 years. CONCLUSIONS: The revised 2016 model is an improvement on previous models. Paediatric HIV models will continue to evolve as further improvements are made to the assumptions. Commodities forecasting and programme planning rely on these estimates, and increasing accuracy will be critical to enable effective scale-up and optimal use of resources. Efforts are needed to improve empirical measures of HIV prevalence, incidence, and mortality among children.
OBJECTIVE: Estimated numbers of children living with HIV determine programmatic and treatment needs. We explain the changes made to the UNAIDS estimates between 2015 and 2016, and describe the challenges around these estimates. METHODS: Estimates of children newly infected, living with HIV, and dying of AIDS are developed by country teams using Spectrum software. Spectrum files are available for 160 countries, which represent 98% of the global population. In 2016, the methods were updated to reflect the latest evidence on mother-to-child HIV transmission and improved assumptions on the age children initiate antiretroviral therapy. We report updated results using the 2016 model and validate these estimates against mother-to-child transmission rates and HIV prevalence from population-based surveys for the survey year. RESULTS: The revised 2016 model estimates 27% fewer children living with HIV in 2014 than the 2015 model, primarily due to changes in the probability of mother-to-child transmission among women with incident HIV during pregnancy. The revised estimates were consistent with population-based surveys of HIV transmission and HIV prevalence among children aged 5-9 years, but were lower than surveys among children aged 10-14 years. CONCLUSIONS: The revised 2016 model is an improvement on previous models. Paediatric HIV models will continue to evolve as further improvements are made to the assumptions. Commodities forecasting and programme planning rely on these estimates, and increasing accuracy will be critical to enable effective scale-up and optimal use of resources. Efforts are needed to improve empirical measures of HIV prevalence, incidence, and mortality among children.
Authors: Romain Silhol; Simon Gregson; Constance Nyamukapa; Mutsa Mhangara; Janet Dzangare; Elizabeth Gonese; Jeffrey W Eaton; Kelsey K Case; Mary Mahy; John Stover; Owen Mugurungi Journal: AIDS Date: 2017-04 Impact factor: 4.177
Authors: Milly Marston; Renaud Becquet; Basia Zaba; Lawrence H Moulton; Glenda Gray; Hoosen Coovadia; Max Essex; Didier K Ekouevi; Debra Jackson; Anna Coutsoudis; Charles Kilewo; Valériane Leroy; Stefan Wiktor; Ruth Nduati; Philippe Msellati; François Dabis; Marie-Louise Newell; Peter D Ghys Journal: Int J Epidemiol Date: 2011-01-18 Impact factor: 7.196
Authors: Renaud Becquet; Milly Marston; François Dabis; Lawrence H Moulton; Glenda Gray; Hoosen M Coovadia; Max Essex; Didier K Ekouevi; Debra Jackson; Anna Coutsoudis; Charles Kilewo; Valériane Leroy; Stefan Z Wiktor; Ruth Nduati; Philippe Msellati; Basia Zaba; Peter D Ghys; Marie-Louise Newell Journal: PLoS One Date: 2012-02-23 Impact factor: 3.240