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Modelling HIV incidence and survival from age-specific seroprevalence after antiretroviral treatment scale-up in rural South Africa

Modelling HIV incidence and survival from age-specific seroprevalence after antiretroviral treatment scale-up in rural South Africa
Modelling HIV incidence and survival from age-specific seroprevalence after antiretroviral treatment scale-up in rural South Africa
Objective: Our study uses sex-specific and age-specific HIV prevalence data from an ongoing population-based demographic and HIV survey to infer HIV incidence and survival in rural KwaZulu-Natal between 2003 and 2011, a period when antiretroviral treatment (ART) was rolled out on a large scale.

Design: Catalytic mathematical model for estimating HIV incidence and differential survival in HIV-infected persons on multiple rounds of HIV seroprevalence.

Methods: We evaluate trends of HIV incidence and survival by estimating parameters separately for women and men aged 15-49 years during three calendar periods (2003-2005, 2006-2008, 2009-2011) reflecting increasing ART coverage. We compare model-based estimates of HIV incidence with observed cohort-based estimates from the longitudinal HIV surveillance.

Results: Median survival after HIV infection increased significantly between 2003-2005 and 2009-2011 from 10.0 [95% confidence interval (CI) 8.8-11.2] to 14.2 (95% CI 12.6-15.8) years in women (P < 0.001) and from 10.0 (95% CI 9.2-10.8) to 14.0 (95% CI 10.6-17.4) years in men (P = 0.02). Our model suggests no statistically significant reduction of HIV incidence in the age-group 15-49 years in 2009-2011 compared with 2003-2005. Age-specific and sex-specific model-based HIV incidence estimates were in good agreement with observed cohort-based estimates from the ongoing HIV surveillance.

Conclusion: Our catalytic modelling approach using cross-sectional age-specific HIV prevalence data could be useful to monitor trends of HIV incidence and survival in other African settings with a high ART coverage.

2471-2479
Mossong, J.
697a19d4-a550-45ba-b8b3-a0acdb68bf5a
Grapsa, E.
bf92588b-2197-4e5e-abc3-6bd4d9018756
Tanser, F.
b4ce79a2-0bf2-4021-89ad-0e759e2e2fc8
Bärnighausen, T
173f79c5-c1d3-4b20-9562-59eeb2a7ebf1
Newell, M-L.
c6ff99dd-c23b-4fef-a846-a221fe2522b3
Mossong, J.
697a19d4-a550-45ba-b8b3-a0acdb68bf5a
Grapsa, E.
bf92588b-2197-4e5e-abc3-6bd4d9018756
Tanser, F.
b4ce79a2-0bf2-4021-89ad-0e759e2e2fc8
Bärnighausen, T
173f79c5-c1d3-4b20-9562-59eeb2a7ebf1
Newell, M-L.
c6ff99dd-c23b-4fef-a846-a221fe2522b3

Mossong, J., Grapsa, E., Tanser, F., Bärnighausen, T and Newell, M-L. (2013) Modelling HIV incidence and survival from age-specific seroprevalence after antiretroviral treatment scale-up in rural South Africa. AIDS, 27 (15), 2471-2479. (doi:10.1097/01.aids.0000432475.14992.da).

Record type: Article

Abstract

Objective: Our study uses sex-specific and age-specific HIV prevalence data from an ongoing population-based demographic and HIV survey to infer HIV incidence and survival in rural KwaZulu-Natal between 2003 and 2011, a period when antiretroviral treatment (ART) was rolled out on a large scale.

Design: Catalytic mathematical model for estimating HIV incidence and differential survival in HIV-infected persons on multiple rounds of HIV seroprevalence.

Methods: We evaluate trends of HIV incidence and survival by estimating parameters separately for women and men aged 15-49 years during three calendar periods (2003-2005, 2006-2008, 2009-2011) reflecting increasing ART coverage. We compare model-based estimates of HIV incidence with observed cohort-based estimates from the longitudinal HIV surveillance.

Results: Median survival after HIV infection increased significantly between 2003-2005 and 2009-2011 from 10.0 [95% confidence interval (CI) 8.8-11.2] to 14.2 (95% CI 12.6-15.8) years in women (P < 0.001) and from 10.0 (95% CI 9.2-10.8) to 14.0 (95% CI 10.6-17.4) years in men (P = 0.02). Our model suggests no statistically significant reduction of HIV incidence in the age-group 15-49 years in 2009-2011 compared with 2003-2005. Age-specific and sex-specific model-based HIV incidence estimates were in good agreement with observed cohort-based estimates from the ongoing HIV surveillance.

Conclusion: Our catalytic modelling approach using cross-sectional age-specific HIV prevalence data could be useful to monitor trends of HIV incidence and survival in other African settings with a high ART coverage.

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More information

Published date: 24 September 2013
Organisations: Human Development & Health

Identifiers

Local EPrints ID: 359461
URI: http://eprints.soton.ac.uk/id/eprint/359461
PURE UUID: 1e129277-efc0-4f84-9bab-e97cadfde764
ORCID for M-L. Newell: ORCID iD orcid.org/0000-0002-1074-7699

Catalogue record

Date deposited: 04 Nov 2013 11:28
Last modified: 23 Jul 2022 02:07

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Contributors

Author: J. Mossong
Author: E. Grapsa
Author: F. Tanser
Author: T Bärnighausen
Author: M-L. Newell ORCID iD

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