气候变化领域集成服务门户(CCPortal): Large age shifts in HIV-1 incidence patterns in KwaZulu-Natal, South Africa

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DOI	10.1073/pnas.2013164118
	Large age shifts in HIV-1 incidence patterns in KwaZulu-Natal, South Africa
	Akullian A.; Vandormael A.; Miller J.C.; Bershteyn A.; Wenger E.; Cuadros D.; Gareta D.; Bärnighausen T.; Herbst K.; Tanser F.
发表日期	2021
ISSN	0027-8424
卷号	118 期号:28
英文摘要	Recent declines in adult HIV-1 incidence have followed the large-scale expansion of antiretroviral therapy and primary HIV prevention across high-burden communities of sub-Saharan Africa. Mathematical modeling suggests that HIV risk will decline disproportionately in younger adult age-groups as interventions scale, concentrating new HIV infections in those >age 25 over time. Yet, no empirical data exist to support these projections. We conducted a population-based cohort study over a 16-y period (2004 to 2019), spanning the early scale-up of antiretroviral therapy and voluntary medical male circumcision, to estimate changes in the age distribution of HIV incidence in a hyperepidemic region of KwaZulu-Natal, South Africa, where adult HIV incidence has recently declined. Median age of HIV seroconversion increased by 5.5 y in men and 3.0 y in women, and the age of peak HIV incidence increased by 5.0 y in men and 2.0 y in women. Incidence declined disproportionately among young men (64% in men 15 to 19, 68% in men 20 to 24, and 46% in men 25 to 29) and young women (44% in women 15 to 19, 24% in women 20 to 24) comparing periods pre- versus post-universal test and treat. Incidence was stable (<20% change) in women aged 30 to 39 and men aged 30 to 34. Age shifts in incidence occurred after 2012 and were observed earlier in men than in women. These results provide direct epidemiological evidence of the changing demographics of HIV risk in sub-Saharan Africa in the era of large-scale treatment and prevention. More attention is needed to address lagging incidence decline among older individuals. © 2021 National Academy of Sciences. All rights reserved.
英文关键词	Age distribution; Antiretroviral therapy; HIV incidence; HIV prevention
语种	英语
来源期刊	Proceedings of the National Academy of Sciences of the United States of America
文献类型	期刊论文
条目标识符	http://gcip.llas.ac.cn/handle/2XKMVOVA/238868
作者单位	Institute for Disease Modeling, Bill and Melinda Gates Foundation, Seattle, WA 98109, United States; Department of Global Health, University of Washington, Seattle, WA 98195, United States; Heidelberg Institute for Global Health, Heidelberg University, Heidelberg, 69120, Germany; KwaZulu-Natal Research and Innovation Sequencing Platform, University of KwaZulu-Natal, Durban, 4001, South Africa; School of Engineering and Mathematical Sciences, La Trobe University, Melbourne, VIC 3086, Australia; Department of Population Health, New York University Grossman School of Medicine, New York, NY 10016, United States; Department of Geography and Geographic Information Science, University of Cincinnati, Cincinnati, OH 45221, United States; Africa Health Research Institute, KwaZulu-Natal, 4001, South Africa; Medical Research Council, Wits-Agincourt Unit, University of the Witwatersrand, Johannesburg, 2193, South Africa; National Department of Science and Innovation, Medical Research Council, South African Popula...
推荐引用方式 GB/T 7714	Akullian A.,Vandormael A.,Miller J.C.,et al. Large age shifts in HIV-1 incidence patterns in KwaZulu-Natal, South Africa[J],2021,118(28).
APA	Akullian A..,Vandormael A..,Miller J.C..,Bershteyn A..,Wenger E..,...&Tanser F..(2021).Large age shifts in HIV-1 incidence patterns in KwaZulu-Natal, South Africa.Proceedings of the National Academy of Sciences of the United States of America,118(28).
MLA	Akullian A.,et al."Large age shifts in HIV-1 incidence patterns in KwaZulu-Natal, South Africa".Proceedings of the National Academy of Sciences of the United States of America 118.28(2021).