HIV prevalence among adults aged ≥ 15 years (per 100 000 population)
Rationale for use
HIV and AIDS has become a major public health problem in many countries and monitoring the course of the epidemic and impact of interventions is crucial. Both the Millennium Development Goals (MDG) and the United Nations General Assembly Special Session on HIV and AIDS (UNGAS) have set goals of reducing HIV prevalence.
The goal in the response to HIV is to reduce HIV infection. As the highest rates of new HIV infections typically occur in young adults, more than 180 countries have committed themselves to achieving major reductions in HIV prevalence among young people—a 25% reduction in the most affected countries by 2005 and a 25% reduction globally by 2010. (UNGASS, MDGS)
Definition
Percentage of adults 15–49 who are HIV infected.
Associated terms
For surveillance purposes, HIV infection is diagnosed through HIV testing , according to the HIV surveillance testing strategies recommended by WHO/UNAIDS HIV/AIDS/STI surveillance working group.
Data sources
HIV surveillance: For generalized epidemics, antenatal clinic attendees and population based surveys are primary sources of information. In concentrated and low level epidemics (where HIV prevalence in pregnant women is below 1%), surveillance among populations with high risk behaviours , 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), AIDS Indicator Surveys (AIS).
Methods of estimation
HIV prevalence data from HIV sentinel surveillance systems, which may include national population surveys with HIV testing, are used to estimate HIV prevalence using standardized tools and methods of estimation developed by UNAIDS and WHO in collaboration with the UNAIDS Reference Group on Estimation, Modelling and Projections. Tools for estimating the level of HIV infection are different for generalized epidemics, and concentrated or low level epidemic.
Disaggregation
By sex, location (urban/rural, major regions/provinces).
References
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Sexually Transmitted Infections
British Medical Journal. Methods and tools for HIV/AIDS estimates and projections. Vol, supp1. August 2004. Sexually Transmitted Infections, Special Issue, British Medical Journal, 2004. -
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
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 -
Guidelines for measuring national HIV prevalence in population -based survey
Guidelines for measuring national HIV prevalence in population -based survey. UNAIDS/WHO working group on global HIV/AIDS and STI surveillance. ISBN 92 4 159370 9
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 15 to 49 years old. Although countries are moving towards collecting better data on young people, mainly by capturing data on young pregnant women attending antenatal clinics or national population based surveys, comparable data availability is still limited. In 2006 only 6 countries were able to perform analysis on HIV prevalence among young people. Analysis of trends on consistent sites have been proposed as a an alternative to tool to assess recent rends and countries have been encouraged to collect report HIV surveillance data by age breakdown.