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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Modeling the epidemiological impact of the UNAIDS 2025 targets to end AIDS as a public health threat by 2030
PLoS Medicine, Volume 18, No. 10, Article e1003831, Year 2021
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Description
Background UNAIDS has established new program targets for 2025 to achieve : the goal of eliminating AIDS as a public health threat by 2030. This study reports on efforts to use mathematical models to estimate the impact of achieving those targets. Methods and findings We simulated the impact of achieving the targets at country level using the Goals model, a mathematical simulation model of HIV epidemic dynamics that includes the impact of prevention and treatment interventions. For 77 high-burden countries, we fit the model to surveillance and survey data for 1970 to 2020 and then projected the impact of achieving the targets for the period 2019 to 2030. Results from these 77 countries were extrapolated to produce estimates for 96 others. Goals model results were checked by comparing against projections done with the Optima HIV model and the AIDS Epidemic Model (AEM) for selected countries. We included estimates of the impact of societal enablers (access to justice and law reform, stigma and discrimination elimination, and gender equality) and the impact of Coronavirus Disease 2019 (COVID-19). Results show that achieving the 2025 targets would reduce new annual infections by 83% (71% to 86% across regions) and AIDS-related deaths by 78% (67% to 81% across regions) by 2025 compared to 2010. Lack of progress on societal enablers could endanger these achievements and result in as many as 2.6 million (44%) cumulative additional new HIV infections and 440,000 (54%) more AIDS-related deaths between 2020 and 2030 compared to full achievement of all targets. COVID-19–related disruptions could increase new HIV infections and AIDS-related deaths by 10% in the next 2 years, but targets could still be achieved by 2025. Study limitations include the reliance on self-reports for most data on behaviors, the use of intervention effect sizes from published studies that may overstate intervention impacts outside of controlled study settings, and the use of proxy countries to estimate the impact in countries with fewer than 4,000 annual HIV infections. Conclusions The new targets for 2025 build on the progress made since 2010 and represent ambitious short-term goals. Achieving these targets would bring us close to the goals of reducing new HIV infections and AIDS-related deaths by 90% between 2010 and 2030. By 2025, global piledforthoseusedthroughoutthetext new infections and AIDS:Pleaseverifythatallentriesarecorrect deaths would drop to 4.4 and : 3.9 per 100,000 population, and the number of people living with HIV (PLHIV) would be declining. There would be 32 million people on treatment, and they would need continuing support for their lifetime. Incidence for the total global population would be below 0.15% everywhere. The number of PLHIV would start declining by 2023. © 2021 Stover et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Available Materials
https://efashare.b-cdn.net/share/pmc/articles/PMC8559943/bin/pmed.1003831.s001.docx
https://efashare.b-cdn.net/share/pmc/articles/PMC8559943/bin/pmed.1003831.s002.docx
https://efashare.b-cdn.net/share/pmc/articles/PMC8559943/bin/pmed.1003831.s003.docx
https://efashare.b-cdn.net/share/pmc/articles/PMC8559943/bin/pmed.1003831.s004.docx
https://efashare.b-cdn.net/share/pmc/articles/PMC8559943/bin/pmed.1003831.s005.docx
https://efashare.b-cdn.net/share/pmc/articles/PMC8559943/bin/pmed.1003831.s006.docx
https://efashare.b-cdn.net/share/pmc/articles/PMC8559943/bin/pmed.1003831.s007.xlsx
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https://efashare.b-cdn.net/share/pmc/articles/PMC8559943/bin/pmed.1003831.s010.docx
https://efashare.b-cdn.net/share/pmc/articles/PMC8559943/bin/pmed.1003831.s011.docx
Authors & Co-Authors
Stover, John
United States, Glastonbury
Avenir Health
Glaubius, Robert L.
United States, Glastonbury
Avenir Health
Teng, Yu
United States, Glastonbury
Avenir Health
Kelly, Sherrie L.
Australia, Melbourne
Burnet Institute
Brown, Tim
United States, Honolulu
East-west Center
Hallett, Timothy B.
United Kingdom, London
Medical Research Council
Revill, Paul A.
United Kingdom, York
University of York
Bärnighausen, Till Winfried
Germany, Heidelberg
Universität Heidelberg
Phillips, Andrew N.
United Kingdom, London
University College London
Fontaine, Christopher
Switzerland, Geneva
Unaids
Frescura, Luisa
Switzerland, Geneva
Unaids
Izazola-Licea, José Antonio
Switzerland, Geneva
Unaids
Semini, Iris
Switzerland, Geneva
Unaids
Godfrey-Faussett, P. D.
Switzerland, Geneva
Unaids
de Lay, Paul R.
Unknown Affiliation
Benzaken, Adèle Schwartz
Unknown Affiliation
Ghys, Peter Denis
Switzerland, Geneva
Unaids
Statistics
Citations: 37
Authors: 17
Affiliations: 8
Identifiers
Doi:
10.1371/journal.pmed.1003831
ISSN:
15491277
Research Areas
Covid
Health System And Policy
Infectious Diseases
Study Design
Randomised Control Trial
Cross Sectional Study
Cohort Study
Study Approach
Quantitative