The evaluation of global epidemic of HIV/AIDS with a novel approach using country-specific counts of HIV infections and three rates controlled for population and geographic area

摘要

Background:The human immunodeficiency virus/acquired immunodeficiency syndrome(HIV/AIDS)epidemic is a typical global health concern.The impact of HIV/AIDS is global,and we cannot effectively solve the problem without a global effort.In this study,we report our research on global HIV/AIDS control with an innovative fourdimensional approach.Methods:Countries(n=148)with data available on area size,total population,and the total number of persons living with HIV(PLWH)were included.The HIV epidemic across the globe was described using 4 indicators,including the total count,population-based P rate,geographic area-based G rate,and population and geographic area-based PG rate.Results:A total of 35,426,911 PLWH were included,with a global prevalence rate of 0.51 per 1,000 population.The total PLWH count provided data on resource allocation in individual countries to improve HIV/AIDS care;and the top five countries with the highest PLWH counts were South Africa(7,000),Nigeria(3,500),India(2,100),Kenya(1,500),and Mozambique(1,500).The other three indicators provide a measure to assess the global risk profile of HIV transmission and to provide information on HIV/AIDS prevention strategies.The top five countries with the highest P rates(per 1,000 persons)were Swaziland(170.9),Botswana(154.7),Lesotho(145.2),South Africa(127.4),and Zimbabwe(89.7);the top five countries with the highest G rates(per 100 km2)were Swaziland(1,279.1),Malawi(1,039.5),Lesotho(1,021.1),Rwanda(810.7),and Uganda(748.1);and the top five countries with highest PG rates(per 1,000,000 persons per 100 km2)were Barbados(2,127.9),Swaziland(993.8),Lesotho(478.3),Malta(375.0),and Mauritius(319.7).With PG rate,we detected countries in two hotspots(south and middle Africa and the Caribbean region)and one belt across the Euro-Asian region with high risks of HIV transmission.Conclusions:This study expanded the conventional measures by adding two new indicators,thus forming a new four-dimensional framework to quantify the global HIV epidemic.In addition to gaining a better insight into the epidemic than before,study findings provide new data on country-level and global efforts to end the AIDS epidemic by 2030.