Defining control of HIV epidemics

Lancet HIV. 2018 Nov;5(11):e667-e670. doi: 10.1016/S2352-3018(18)30178-4. Epub 2018 Oct 9.

Abstract

Although the HIV pandemic remains a global crisis, much progress has been made in implementing programmes to treat and prevent HIV infection. To guide prioritisation of efforts, the metric by which a country can declare its HIV epidemic as controlled has become increasingly relevant. Herein, we evaluate the merits of the four control criteria proposed by UNAIDS: percentage reduction in incidence over time; ratio of incidence to mortality; ratio of incidence to prevalence; and annual incidence. Using a transmission model to generate projections of demography, incidence, and mortality, we highlight potential pitfalls associated with each of the first three criteria. A definition of control based on annual incidence would provide clarity and consistency across settings.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Benchmarking
  • Epidemics / prevention & control*
  • Epidemics / statistics & numerical data
  • Forecasting
  • Global Health / standards*
  • Global Health / trends
  • HIV Infections / epidemiology*
  • HIV Infections / mortality
  • HIV Infections / prevention & control*
  • Humans
  • Incidence
  • Prevalence