HIV prevalence among adults aged 15-49 years (%)
HIV prevalence among the population aged 15-49 years
Rationale for use
HIV and AIDS has become a major public health problem in almost every country and monitoring the course of the epidemic is crucial. Both the MDGs and the United Nations General Assembly Special Session on HIV and AIDS have set goals of reducing HIV prevalence.
Definition
Percent of people with HIV infection among all people aged 15-49 years.
Associated terms
For surveillance purposes, HIV infection is diagnosed through the HIV antibody test, according to, as a minimum, the WHO/UNAIDS surveillance guidelines.
Data sources
HIV surveillance: Generalized epidemics, antenatal clinic attendees as primary sources of information. In concentrated and low level epidemics (where HIV prevalence in the general population is below 1%), surveillance among risk populations, e.g. injecting drug users, men who have sex with men and sex workers, should be the focus of surveillance.
Household surveys: Inclusion of HIV testing is being increasingly adopted by countries e.g. Demographic and Health Surveys (DHS).
Methods of estimation
HIV prevalence data from surveillance systems, which may include national surveys with HIV testing, are used to estimate HIV prevalence using standardized methods of estimation developed by UNAIDS and WHO in collaboration with the UNAIDS Reference Group on Estimation, Modelling and Projections. For generalized epidemics, a software package called Epidemic Projection Package (EPP) is used to fit a curve to empirical data points. For concentrated and low level epidemics a spreadsheet method is used that requires inputs on estimated size and HIV prevalence in risk populations.
Disaggregation
By sex, location (urban/rural, major regions/provinces), and socio-economic characteristics (e.g. education level, wealth quintile).
References
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British Medical Journal
Sexually Transmitted Infections, Special Issue, British Medical Journal, 2004. -
AIDS Online
The UNAIDS Reference Group on Estimates, Modelling and Projections. Improved methods and assumptions for estimation of the HIV/AIDS epidemic and its impact: Recommendations of the UNAIDS Reference Group on Estimates, Modelling and Projections. AIDS 2002; 16:W1-W16. -
Guidelines for using HIV Testing Technologies in Surveillance
Guidelines for using HIV Testing Technologies in Surveillance: Selection, evaluation and Implementation. Geneva. World Health Organization, Joint United Nations Programme , 2001
Database
Comments
The main indicator proposed for monitoring progress towards achieving the international goals is HIV prevalence among young people aged 15-24 years which is a better proxy for monitoring HIV incidence than prevalence among ages 15-49 years. Although countries are moving towards collecting better data on young people, mainly by capturing data on young pregnant women attending antenatal clinics, comparable data availability is still limited.
