@article{3000315,
    title = "Global, regional, and national incidence, prevalence, and mortality of HIV, 1980-2017, and forecasts to 2030, for 195 countries and territories: A systematic analysis for the Global Burden of Diseases, Injuries, and Risk Factors Study 2017",
    author = "Frank, T.D. and Carter, A. and Jahagirdar, D. and Biehl, M.H. and Douwes-Schultz, D. and Larson, S.L. and Arora, M. and Dwyer-Lindgren, L. and Steuben, K.M. and Abbastabar, H. and Abu-Raddad, L.J. and Abyu, D.M. and Adabi, M. and Adebayo, O.M. and Adekanmbi, V. and Adetokunboh, O.O. and Ahmadi, A. and Ahmadi, K. and Ahmadian, E. and Ahmadpour, E. and Ahmed, M.B. and Akal, C.G. and Alahdab, F. and Alam, N. and Albertson, S.B. and Alemnew, B.T.T. and Alene, K.A. and Alipour, V. and Alvis-Guzman, N. and Amini, S. and Anbari, Z. and Anber, N.H. and Anjomshoa, M. and Antonio, C.A.T. and Arabloo, J. and Aremu, O. and Areri, H.A. and Asfaw, E.T. and Ashagre, A.F. and Asmelash, D. and Asrat, A.A. and Avokpaho, E.F.G.A. and Awasthi, A. and Awoke, N. and Ayanore, M.A. and Azari, S. and Badawi, A. and Bagherzadeh, M. and Banach, M. and Barac, A. and Bärnighausen, T.W. and Basu, S. and Bedi, N. and Behzadifar, M. and Bekele, B.B. and Belay, S.A. and Belay, Y.B. and Belayneh, Y.M.M. and Berhane, A. and Bhat, A.G. and Bhattacharyya, K. and Biadgo, B. and Bijani, A. and Shahdaat Bin Sayeed, M. and Bitew, H. and Blinov, A. and Bogale, K.A. and Bojia, H.A. and Burugina Nagaraja, S.B.N. and Butt, Z.A. and Cahuana-Hurtado, L. and Campuzano Rincon, J.C. and Carvalho, F. and Chattu, V.K. and Christopher, D.J. and Chu, D.-T. and Crider, R. and Dahiru, T. and Dandona, L. and Dandona, R. and Daryani, A. and Das Neves, J. and De Neve, J.-W. and Degenhardt, L. and Demeke, F.M. and Demis, A.B.B. and Demissie, D.B. and Demoz, G.T. and Deribe, K. and Des Jarlais, D. and Dhungana, G.P. and Diaz, D. and Djalalinia, S. and Do, H.P. and Doan, L.P. and Duber, H. and Dubey, M. and Dubljanin, E. and Duken, E.E. and Duko Adema, B. and Effiong, A. and Eftekhari, A. and El Sayed Zaki, M. and El-Jaafary, S.I. and El-Khatib, Z. and Elsharkawy, A. and Endries, A.Y. and Eskandarieh, S. and Eyawo, O. and Farzadfar, F. and Fatima, B. and Fentahun, N. and Fernandes, E. and Filip, I. and Fischer, F. and Folayan, M.O. and Foroutan, M. and Fukumoto, T. and Fullman, N. and Garcia-Basteiro, A.L. and Gayesa, R.T. and Gebremedhin, K.B. and Gebremeskel, G.G. and Gebreyohannes, K.K. and Gedefaw, G.A. and Gelaw, B.K. and Gesesew, H.A. and Geta, B. and Gezae, K.E. and Ghadiri, K. and Ghashghaee, A. and Ginindza, T.T.G. and Gugnani, H.C. and Guimarães, R.A. and Haile, M.T. and Hailu, G.B. and Haj-Mirzaian, A. and Haj-Mirzaian, A. and Hamidi, S. and Handanagic, S. and Handiso, D.W. and Hanfore, L.K. and Hasanzadeh, A. and Hassankhani, H. and Hassen, H.Y. and Hay, S.I. and Henok, A. and Hoang, C.L. and Hosgood, H.D. and Hosseinzadeh, M. and Hsairi, M. and Ibitoye, S.E. and Idrisov, B. and Ikuta, K.S. and Ilesanmi, O.S. and Irvani, S.S.N. and Iwu, C.J. and Jacobsen, K.H. and James, S.L. and Jenabi, E. and Jha, R.P. and Jonas, J.B. and Jorjoran Shushtari, Z. and Kabir, A. and Kabir, Z. and Kadel, R. and Kasaeian, A. and Kassa, B. and Kassa, G.M. and Kassa, T.D. and Kayode, G.A. and Kebede, M.M. and Kefale, A.T. and Kengne, A.P. and Khader, Y.S. and Khafaie, M.A. and Khalid, N. and Khan, E.A. and Khan, G. and Khan, J. and Khang, Y.-H. and Khatab, K. and Khazaei, S. and Khoja, A.T. and Kiadaliri, A.A. and Kim, Y.J. and Kisa, A. and Kisa, S. and Kochhar, S. and Komaki, H. and Koul, P.A. and Koyanagi, A. and Kuate Defo, B. and Kumar, G.A. and Kumar, M. and Kuupiel, D. and Lal, D.K. and Lee, J.J.-H. and Lenjebo, T.L. and Leshargie, C.T. and Macarayan, E.R.K. and Maddison, E.R. and Magdy Abd El Razek, H. and Magis-Rodriguez, C. and Mahasha, P.W. and Majdan, M. and Majeed, A. and Malekzadeh, R. and Manafi, N. and Mapoma, C.C. and Martins-Melo, F.R. and Masaka, A. and Mayenga, E.N.L. and Mehta, V. and Meles, G.G. and Meles, H.G. and Melese, A. and Melku, M. and Memiah, P.T.N. and Memish, Z.A. and Mena, A.T. and Mendoza, W. and Mengistu, D.T. and Mengistu, G. and Meretoja, T.J. and Mestrovic, T. and Miller, T.R. and Moazen, B. and Mohajer, B. and Mohamadi-Bolbanabad, A. and Mohammad, K.A. and Mohammad, Y. and Mohammad Darwesh, A. and Mohammad Gholi Mezerji, N. and Mohammadi, M. and Mohammadibakhsh, R. and Mohammadoo-Khorasani, M. and Mohammed, J.A. and Mohammed, S. and Mohebi, F. and Mokdad, A.H. and Moodley, Y. and Moossavi, M. and Moradi, G. and Moradi-Lakeh, M. and Moschos, M.M. and Mossie, T.B. and Mousavi, S.M. and Muchie, K.F. and Muluneh, A.G. and Muriithi, M.K. and Mustafa, G. and Muthupandian, S. and Nagarajan, A.J. and Naik, G. and Najafi, F. and Nazari, J. and Ndwandwe, D.E. and Nguyen, C.T. and Nguyen, H.L.T. and Nguyen, S.H. and Nguyen, T.H. and Ningrum, D.N.A. and Nixon, M.R. and Nnaji, C.A. and Noroozi, M. and Noubiap, J.J. and Nourollahpour Shiadeh, M. and Obsa, M.S. and Odame, E.A. and Ofori-Asenso, R. and Ogbo, F.A. and Okoro, A. and Oladimeji, O. and Olagunju, A.T. and Olagunju, T.O. and Olum, S. and Oppong Asante, K. and Oren, E. and Otstavnov, S.S. and Mahesh, P.A. and Padubidri, J.R. and Pakhale, S. and Pakpour, A.H. and Patel, S.K. and Paulos, K. and Pepito, V.C.F. and Peprah, E.K. and Piroozi, B. and Pourshams, A. and Qorbani, M. and Rabiee, M. and Rabiee, N. and Radfar, A. and Rafay, A. and Rafiei, A. and Rahim, F. and Rahimi-Movaghar, A. and Rahimi-Movaghar, V. and Rahman, S.U. and Ranabhat, C.L. and Rawaf, S. and Reis, C. and Renjith, V. and Reta, M.A. and Rezai, M.S. and Rios González, C.M. and Merdassa Roro, E.E.M. and Rostami, A. and Rubino, S. and Saeedi Moghaddam, S. and Safari, S. and Sagar, R. and Sahraian, M.A. and Salem, M.R.R. and Salimi, Y. and Salomon, J.A. and Sambala, E.Z. and Samy, A.M. and Sartorius, B. and Satpathy, M. and Sawhney, M. and Sayyah, M. and Schutte, A.E. and Sepanlou, S.G. and Seyedmousavi, S. and Shabaninejad, H. and Shaheen, A.A. and Shaikh, M.A. and Shallo, S.A. and Shamsizadeh, M. and Sharifi, H. and Shibuya, K. and Shin, J.I. and Shirkoohi, R. and Silva, D.A.S. and Silveira, D.G.A. and Singh, J.A. and Sisay, M.M.M. and Sisay, M. and Sisay, S. and Smith, A.E. and Sokhan, A. and Somayaji, R. and Soshnikov, S. and Stein, D.J. and Sufiyan, M.B. and Sunguya, B.F. and Sykes, B.L. and Tadesse, B.T. and Tadesse, D.B. and Tamirat, K.S. and Taveira, N. and Tekelemedhin, S.W. and Temesgen, H.D. and Tesfay, F.H. and Teshale, M.Y. and Thapa, S. and Tlaye, K.G. and Topp, S.M. and Tovani-Palone, M.R. and Tran, B.X. and Tran, K.B. and Ullah, I. and Unnikrishnan, B. and Uthman, O.A. and Veisani, Y. and Vladimirov, S.K. and Wada, F.W. and Waheed, Y. and Weldegwergs, K.G. and Weldesamuel, G.T.T. and Westerman, R. and Wijeratne, T. and Wolde, H.F. and Wondafrash, D.Z. and Wonde, T.E. and Wondmagegn, B.Y. and Yeshanew, A.G. and Yilma, M.T. and Yimer, E.M. and Yonemoto, N. and Yotebieng, M. and Youm, Y. and Yu, C. and Zaidi, Z. and Zarghi, A. and Zenebe, Z.M. and Zewale, T.A. and Ziapour, A. and Zodpey, S. and Naghavi, M. and Vollset, S.E. and Wang, H. and Lim, S.S. and Kyu, H.H. and Murray, C.J.L. and GBD 2017 HIV collaborators",
    journal = "The Lancet HIV",
    year = "2019",
    volume = "6",
    number = "12",
    pages = "e831-e859",
    publisher = "Elsevier Ireland Ltd",
    issn = "2352-3018",
    doi = "10.1016/S2352-3018(19)30196-1",
    keywords = "anti human immunodeficiency virus agent, adolescent;  adult;  Afghanistan;  Africa south of the Sahara;  aged;  Albania;  Algeria;  Andorra;  Angola;  antiretroviral therapy;  Argentina;  Armenia;  Article;  Australia;  Austria;  Azerbaijan;  Bahamas;  Bahrain;  Bangladesh;  Barbados;  Belarus;  Belgium;  Belize;  Bermuda;  Bhutan;  Bolivia;  Bosnia and Herzegovina;  Botswana;  Brazil;  Brunei Darussalam;  Bulgaria;  Burkina Faso;  Burundi;  Cambodia;  Cameroon;  Canada;  Cape Verde;  cause specific survival;  Chad;  child;  Chile;  China;  Colombia;  Comoros;  Congo;  Costa Rica;  Cote d'Ivoire;  Croatia;  Cuba;  Cyprus;  Czech Republic;  Denmark;  disease exacerbation;  disease registry;  Djibouti;  Dominica;  Ecuador;  Egypt;  El Salvador;  Equatorial Guinea;  Eritrea;  Estonia;  Ethiopia;  Federated States of Micronesia;  female;  Fiji;  Finland;  forecasting;  France;  Gabon;  Gambia;  Georgia (republic);  Germany;  Ghana;  global disease burden;  Greece;  Greenland;  Grenada;  groups by age;  Guam;  Guatemala;  Guinea-Bissau;  Guyana;  Haiti;  Honduras;  human;  Human immunodeficiency virus infected patient;  Human immunodeficiency virus infection;  Human immunodeficiency virus prevalence;  Hungary;  Iceland;  incidence;  India;  Indonesia;  infant;  infection risk;  Iran;  Iraq;  Ireland;  Israel;  Italy;  Jamaica;  Japan;  Jordan;  Kazakhstan;  Kenya;  Kiribati;  Kuwait;  Kyrgyzstan;  Laos;  Latvia;  Lebanon;  Lesotho;  Liberia;  Libyan Arab Jamahiriya;  Lithuania;  Luxembourg;  Macedonia (republic);  Madagascar;  major clinical study;  Malawi;  Malaysia;  Maldives;  male;  Mali;  Malta;  Mauritania;  Mauritius;  Mexico;  middle aged;  model;  Moldova;  Mongolia;  Montenegro (republic);  Morocco;  mortality;  Mozambique;  Myanmar;  Namibia;  Nepal;  Netherlands;  New Zealand;  Nicaragua;  Niger;  Nigeria;  North Korea;  Norway;  Oman;  Pacific islands;  Pakistan;  Palestine;  Panama;  Papua New Guinea;  Paraguay;  Peru;  Philippines;  Poland;  Portugal;  prenatal care;  preschool child;  priority journal;  Puerto Rico;  Qatar;  Romania;  Russian Federation;  Rwanda;  Saint Lucia;  Saint Vincent and the Grenadines;  Sao Tome and Principe;  Saudi Arabia;  school child;  Senegal;  Serbia;  seroprevalence;  Seychelles;  Sierra Leone;  Singapore;  Slovakia;  Slovenia;  Somalia;  South Africa;  South Korea;  South Sudan;  Spain;  Sri Lanka;  Sudan;  Suriname;  Sweden;  Switzerland;  Syrian Arab Republic;  Taiwan;  Tajikistan;  Tanzania;  Thailand;  Timor-Leste;  Togo;  Tonga;  Tunisia;  Turkey (republic);  Turkmenistan;  Uganda;  Ukraine;  United Arab Emirates;  United Kingdom;  United States;  Uruguay;  Uzbekistan;  Vanuatu;  Venezuela;  very elderly;  Viet Nam;  Yemen;  young adult;  Zambia;  Zimbabwe;  cause of death;  forecasting;  global disease burden;  history;  Human immunodeficiency virus infection;  incidence;  prevalence;  risk factor;  seroepidemiology, Cause of Death;  Forecasting;  Global Burden of Disease;  History, 20th Century;  History, 21st Century;  HIV Infections;  Humans;  Incidence;  Prevalence;  Risk Factors;  Seroepidemiologic Studies",
    abstract = "Background Understanding the patterns of HIV/AIDS epidemics is crucial to tracking and monitoring the progress of prevention and control efforts in countries. We provide a comprehensive assessment of the levels and trends of HIV/AIDS incidence, prevalence, mortality, and coverage of antiretroviral therapy (ART) for 1980-2017 and forecast these estimates to 2030 for 195 countries and territories. Methods We determined a modelling strategy for each country on the basis of the availability and quality of data. For countries and territories with data from population-based seroprevalence surveys or antenatal care clinics, we estimated prevalence and incidence using an open-source version of the Estimation and Projection Package - a natural history model originally developed by the UNAIDS Reference Group on Estimates, Modelling, and Projections. For countries with cause-specific vital registration data, we corrected data for garbage coding (ie, deaths coded to an intermediate, immediate, or poorly defined cause) and HIV misclassification. We developed a process of cohort incidence bias adjustment to use information on survival and deaths recorded in vital registration to back-calculate HIV incidence. For countries without any representative data on HIV, we produced incidence estimates by pulling information from observed bias in the geographical region. We used a re-coded version of the Spectrum model (a cohort component model that uses rates of disease progression and HIV mortality on and off ART) to produce agesex- specific incidence, prevalence, and mortality, and treatment coverage results for all countries, and forecast these measures to 2030 using Spectrum with inputs that were extended on the basis of past trends in treatment scale-up and new infections. Findings Global HIV mortality peaked in 2006 with 1·95 million deaths (95% uncertainty interval 1·87-2·04) and has since decreased to 0·95 million deaths (0·91-1·01) in 2017. New cases of HIV globally peaked in 1999 (3·16 million, 2·79-3·67) and since then have gradually decreased to 1·94 million (1·63-2·29) in 2017. These trends, along with ART scale-up, have globally resulted in increased prevalence, with 36·8 million (34·8-39·2) people living with HIV in 2017. Prevalence of HIV was highest in southern sub-Saharan Africa in 2017, and countries in the region had ART coverage ranging from 65·7% in Lesotho to 85·7% in eSwatini. Our forecasts showed that 54 countries will meet the UNAIDS target of 81% ART coverage by 2020 and 12 countries are on track to meet 90% ART coverage by 2030. Forecasted results estimate that few countries will meet the UNAIDS 2020 and 2030 mortality and incidence targets. Interpretation Despite progress in reducing HIV-related mortality over the past decade, slow decreases in incidence, combined with the current context of stagnated funding for related interventions, mean that many countries are not on track to reach the 2020 and 2030 global targets for reduction in incidence and mortality. With a growing population of people living with HIV, it will continue to be a major threat to public health for years to come. The pace of progress needs to be hastened by continuing to expand access to ART and increasing investments in proven HIV prevention initiatives that can be scaled up to have population-level impact. © 2019 The Author(s)."
}