Improving estimates of children living with HIV from the Spectrum AIDS Impact Model

Mary Mahy, Martina Penazzato, Andrea Ciaranello, Lynne Mofenson, Constantin Yiannoutsos, Mary Ann Davies, John Stover

Research output: Contribution to journalReview article

15 Citations (Scopus)

Abstract

Objective: Estimated numbers of children living with HIV determine programmatic and treatment needs. We explain the changes made to the UNAIDS estimates between 2015 and 2016, and describe the challenges around these estimates. Methods: Estimates of children newly infected, living with HIV, and dying of AIDS are developed by country teams using Spectrum software. Spectrum files are available for 160 countries, which represent 98% of the global population. In 2016, the methods were updated to reflect the latest evidence on mother-to-child HIV transmission and improved assumptions on the age children initiate antiretroviral therapy. We report updated results using the 2016 model and validate these estimates against mother-to-child transmission rates and HIV prevalence from population-based surveys for the survey year. Results: The revised 2016 model estimates 27% fewer children living with HIV in 2014 than the 2015 model, primarily due to changes in the probability of mother-to-child transmission among women with incident HIV during pregnancy. The revised estimates were consistent with population-based surveys of HIV transmission and HIV prevalence among children aged 5-9 years, but were lower than surveys among children aged 10-14 years. Conclusions: The revised 2016 model is an improvement on previous models. Paediatric HIV models will continue to evolve as further improvements are made to the assumptions. Commodities forecasting and programme planning rely on these estimates, and increasing accuracy will be critical to enable effective scale-up and optimal use of resources. Efforts are needed to improve empirical measures of HIV prevalence, incidence, and mortality among children.

Original languageEnglish (US)
Pages (from-to)S13-S22
JournalAIDS
Volume31
DOIs
StatePublished - Apr 1 2017
Externally publishedYes

Fingerprint

Acquired Immunodeficiency Syndrome
HIV
Mothers
Population
Child Mortality
Developed Countries
Software
Pediatrics
Pregnancy
Surveys and Questionnaires
Incidence
Therapeutics

Keywords

  • antiretroviral therapy
  • models
  • mother-to-child transmission
  • paediatric HIV
  • seroprevalence

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases

Cite this

Mahy, M., Penazzato, M., Ciaranello, A., Mofenson, L., Yiannoutsos, C., Davies, M. A., & Stover, J. (2017). Improving estimates of children living with HIV from the Spectrum AIDS Impact Model. AIDS, 31, S13-S22. https://doi.org/10.1097/QAD.0000000000001306

Improving estimates of children living with HIV from the Spectrum AIDS Impact Model. / Mahy, Mary; Penazzato, Martina; Ciaranello, Andrea; Mofenson, Lynne; Yiannoutsos, Constantin; Davies, Mary Ann; Stover, John.

In: AIDS, Vol. 31, 01.04.2017, p. S13-S22.

Research output: Contribution to journalReview article

Mahy, M, Penazzato, M, Ciaranello, A, Mofenson, L, Yiannoutsos, C, Davies, MA & Stover, J 2017, 'Improving estimates of children living with HIV from the Spectrum AIDS Impact Model', AIDS, vol. 31, pp. S13-S22. https://doi.org/10.1097/QAD.0000000000001306
Mahy, Mary ; Penazzato, Martina ; Ciaranello, Andrea ; Mofenson, Lynne ; Yiannoutsos, Constantin ; Davies, Mary Ann ; Stover, John. / Improving estimates of children living with HIV from the Spectrum AIDS Impact Model. In: AIDS. 2017 ; Vol. 31. pp. S13-S22.
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abstract = "Objective: Estimated numbers of children living with HIV determine programmatic and treatment needs. We explain the changes made to the UNAIDS estimates between 2015 and 2016, and describe the challenges around these estimates. Methods: Estimates of children newly infected, living with HIV, and dying of AIDS are developed by country teams using Spectrum software. Spectrum files are available for 160 countries, which represent 98{\%} of the global population. In 2016, the methods were updated to reflect the latest evidence on mother-to-child HIV transmission and improved assumptions on the age children initiate antiretroviral therapy. We report updated results using the 2016 model and validate these estimates against mother-to-child transmission rates and HIV prevalence from population-based surveys for the survey year. Results: The revised 2016 model estimates 27{\%} fewer children living with HIV in 2014 than the 2015 model, primarily due to changes in the probability of mother-to-child transmission among women with incident HIV during pregnancy. The revised estimates were consistent with population-based surveys of HIV transmission and HIV prevalence among children aged 5-9 years, but were lower than surveys among children aged 10-14 years. Conclusions: The revised 2016 model is an improvement on previous models. Paediatric HIV models will continue to evolve as further improvements are made to the assumptions. Commodities forecasting and programme planning rely on these estimates, and increasing accuracy will be critical to enable effective scale-up and optimal use of resources. Efforts are needed to improve empirical measures of HIV prevalence, incidence, and mortality among children.",
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