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dc.contributor.authorSartorius, Ben_NZ
dc.contributor.authorVanderHeide, JDen_NZ
dc.contributor.authorYang, Men_NZ
dc.contributor.authorGoosmann, EAen_NZ
dc.contributor.authorHon, Jen_NZ
dc.contributor.authorHaeuser, Een_NZ
dc.contributor.authorCork, MAen_NZ
dc.contributor.authorPerkins, Sen_NZ
dc.contributor.authorJahagirdar, Den_NZ
dc.contributor.authorSchaeffer, LEen_NZ
dc.contributor.authorSerfes, ALen_NZ
dc.contributor.authorLeGrand, KEen_NZ
dc.contributor.authorAbbastabar, Hen_NZ
dc.contributor.authorAbebo, ZHen_NZ
dc.contributor.authorAbosetugn, AEen_NZ
dc.contributor.authorAbu-Gharbieh, Een_NZ
dc.contributor.authorAccrombessi, MMKen_NZ
dc.contributor.authorAdebayo, OMen_NZ
dc.contributor.authorAdegbosin, AEen_NZ
dc.contributor.authorAdekanmbi, Ven_NZ
dc.contributor.authorAdetokunboh, OOen_NZ
dc.contributor.authorAdeyinka, DAen_NZ
dc.contributor.authorAhinkorah, BOen_NZ
dc.contributor.authorAhmadi, Ken_NZ
dc.contributor.authorAhmed, MBen_NZ
dc.contributor.authorAkalu, Yen_NZ
dc.contributor.authorAkinyemi, OOen_NZ
dc.contributor.authorAkinyemi, ROen_NZ
dc.contributor.authorAklilu, Aen_NZ
dc.contributor.authorAkunna, CJen_NZ
dc.contributor.authorAlahdab, Fen_NZ
dc.contributor.authorAl-Aly, Zen_NZ
dc.contributor.authorAlam, Nen_NZ
dc.contributor.authorAlamneh, AAen_NZ
dc.contributor.authorAlanzi, TMen_NZ
dc.contributor.authorAlemu, BWen_NZ
dc.contributor.authorAlhassan, RKen_NZ
dc.contributor.authorAli, Ten_NZ
dc.contributor.authorAlipour, Ven_NZ
dc.contributor.authorAmini, Sen_NZ
dc.contributor.authorAncuceanu, Ren_NZ
dc.contributor.authorAnsari, Fen_NZ
dc.contributor.authorAnteneh, ZAen_NZ
dc.contributor.authorAnvari, Den_NZ
dc.contributor.authorAnwer, Ren_NZ
dc.contributor.authorAppiah, SCYen_NZ
dc.contributor.authorArabloo, Jen_NZ
dc.contributor.authorAsemahagn, MAen_NZ
dc.contributor.authorAsghari Jafarabadi, Men_NZ
dc.contributor.authorAsmare, WNen_NZ
dc.contributor.authorAtnafu, DDen_NZ
dc.contributor.authorAtout, MMDWen_NZ
dc.contributor.authorAtreya, Aen_NZ
dc.contributor.authorAusloos, Men_NZ
dc.contributor.authorAwedew, AFen_NZ
dc.contributor.authorAyala Quintanilla, BPen_NZ
dc.contributor.authorAyanore, MAen_NZ
dc.contributor.authorAynalem, YAen_NZ
dc.contributor.authorAyza, MAen_NZ
dc.contributor.authorAzari, Sen_NZ
dc.contributor.authorAzene, ZNen_NZ
dc.contributor.authorBabar, ZUDen_NZ
dc.contributor.authorBaig, AAen_NZ
dc.contributor.authorBalakrishnan, Sen_NZ
dc.contributor.authorBanach, Men_NZ
dc.contributor.authorBärnighausen, TWen_NZ
dc.contributor.authorBasu, Sen_NZ
dc.contributor.authorBayati, Men_NZ
dc.contributor.authorBedi, Nen_NZ
dc.contributor.authorBekuma, TTen_NZ
dc.contributor.authorBezabhe, WMMen_NZ
dc.contributor.authorBhagavathula, ASen_NZ
dc.contributor.authorBhardwaj, Pen_NZ
dc.contributor.authorBhattacharyya, Ken_NZ
dc.contributor.authorBhutta, ZAen_NZ
dc.contributor.authorBibi, Sen_NZ
dc.contributor.authorBikbov, Ben_NZ
dc.contributor.authorBirhan, TAen_NZ
dc.contributor.authorBitew, ZWen_NZ
dc.contributor.authorBockarie, MJen_NZ
dc.contributor.authorBoloor, Aen_NZ
dc.contributor.authorBrady, OJen_NZ
dc.contributor.authorBragazzi, NLen_NZ
dc.contributor.authorBriko, ANen_NZ
dc.contributor.authorBriko, NIen_NZ
dc.contributor.authorBurugina Nagaraja, Sen_NZ
dc.contributor.authorButt, ZAen_NZ
dc.contributor.authorCárdenas, Ren_NZ
dc.contributor.authorCarvalho, Fen_NZ
dc.contributor.authorCharan, Jen_NZ
dc.contributor.authorChatterjee, Sen_NZ
dc.contributor.authorChattu, SKen_NZ
dc.contributor.authorChattu, VKen_NZ
dc.contributor.authorChowdhury, MAKen_NZ
dc.contributor.authorChu, DTen_NZ
dc.contributor.authorCook, AJen_NZ
dc.contributor.authorCormier, NMen_NZ
dc.contributor.authorCowden, RGen_NZ
dc.contributor.authorCulquichicon, Cen_NZ
dc.contributor.authorDagnew, Ben_NZ
dc.date.accessioned2021-06-14T01:51:03Z
dc.date.available2021-06-14T01:51:03Z
dc.date.copyright2021en_NZ
dc.identifier.citationLancet HIV, The, 2021-06-01, Volume 8, Issue 6, Pages e363-e375
dc.identifier.issn2352-3018en_NZ
dc.identifier.issn2352-3018en_NZ
dc.identifier.urihttp://hdl.handle.net/10292/14265
dc.description.abstractBackground: High-resolution estimates of HIV burden across space and time provide an important tool for tracking and monitoring the progress of prevention and control efforts and assist with improving the precision and efficiency of targeting efforts. We aimed to assess HIV incidence and HIV mortality for all second-level administrative units across sub-Saharan Africa. Methods: In this modelling study, we developed a framework that used the geographically specific HIV prevalence data collected in seroprevalence surveys and antenatal care clinics to train a model that estimates HIV incidence and mortality among individuals aged 15–49 years. We used a model-based geostatistical framework to estimate HIV prevalence at the second administrative level in 44 countries in sub-Saharan Africa for 2000–18 and sought data on the number of individuals on antiretroviral therapy (ART) by second-level administrative unit. We then modified the Estimation and Projection Package (EPP) to use these HIV prevalence and treatment estimates to estimate HIV incidence and mortality by second-level administrative unit. Findings: The estimates suggest substantial variation in HIV incidence and mortality rates both between and within countries in sub-Saharan Africa, with 15 countries having a ten-times or greater difference in estimated HIV incidence between the second-level administrative units with the lowest and highest estimated incidence levels. Across all 44 countries in 2018, HIV incidence ranged from 2·8 (95% uncertainty interval 2·1–3·8) in Mauritania to 1585·9 (1369·4–1824·8) cases per 100 000 people in Lesotho and HIV mortality ranged from 0·8 (0·7–0·9) in Mauritania to 676·5 (513·6–888·0) deaths per 100 000 people in Lesotho. Variation in both incidence and mortality was substantially greater at the subnational level than at the national level and the highest estimated rates were accordingly higher. Among second-level administrative units, Guijá District, Gaza Province, Mozambique, had the highest estimated HIV incidence (4661·7 [2544·8–8120·3]) cases per 100 000 people in 2018 and Inhassunge District, Zambezia Province, Mozambique, had the highest estimated HIV mortality rate (1163·0 [679·0–1866·8]) deaths per 100 000 people. Further, the rate of reduction in HIV incidence and mortality from 2000 to 2018, as well as the ratio of new infections to the number of people living with HIV was highly variable. Although most second-level administrative units had declines in the number of new cases (3316 [81·1%] of 4087 units) and number of deaths (3325 [81·4%]), nearly all appeared well short of the targeted 75% reduction in new cases and deaths between 2010 and 2020. Interpretation: Our estimates suggest that most second-level administrative units in sub-Saharan Africa are falling short of the targeted 75% reduction in new cases and deaths by 2020, which is further compounded by substantial within-country variability. These estimates will help decision makers and programme implementers expand access to ART and better target health resources to higher burden subnational areas. Funding: Bill & Melinda Gates Foundation.en_NZ
dc.publisherElsevier
dc.relation.urihttps://www.clinicalkey.com.au/#!/content/playContent/1-s2.0-S2352301821000515
dc.rightsCopyright © 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.
dc.titleSubnational Mapping of HIV Incidence and Mortality Among Individuals Aged 15–49 Years in Sub-Saharan Africa, 2000–18: A Modelling Studyen_NZ
dc.typeJournal Article
dc.rights.accessrightsOpenAccessen_NZ
dc.identifier.doi10.1016/S2352-3018(21)00051-5en_NZ
aut.relation.endpagee375
aut.relation.issue6en_NZ
aut.relation.startpagee363
aut.relation.volume8en_NZ
pubs.elements-id431513
aut.relation.journalThe Lancet HIVen_NZ


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