Demographic change and HIV epidemic projections to 2050 for adolescents and young people aged 15-24
Demographic change and HIV epidemic projections to 2050 for adolescents and young people aged 15-24
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DOI：
10.1080/16549716.2019.1662685
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发表时间：
2019-01-01
影响因子：
2.6
通讯作者：
Lwamba, Chibwe
中科院分区：
文献类型：
--
作者：
Khalifa, Aleya;Stover, John;Lwamba, Chibwe
背景：到2030年结束艾滋病对公共卫生的威胁是一项重大挑战，因为青少年和年轻人中新的艾滋病毒感染人数下降得还不够快，无法遏制这一流行病。艾滋病毒反应缓慢，加上15-24岁青年人口不断增加，可能会影响实现2030年目标的进展。目的：这项分析旨在通过人口预测和艾滋病毒干预措施的最新趋势，描述2010-2050年青少年中艾滋病毒流行的全球和区域趋势。方法：使用148份国家艾滋病毒评估文件预测到2050年的艾滋病毒流行情况。艾滋病毒携带者和新感染艾滋病毒的人数是按性别和五岁年龄组预测的。除了人口数据，预测还基于三个关键假设：艾滋病毒发病率的未来趋势、抗逆转录病毒治疗的覆盖率以及用于预防母婴传播的抗逆转录病毒药物的覆盖率。结果代表了九个地理区域。结果：从2010年到2050年，青少年和年轻人的数量预计将增加10%，而艾滋病毒携带者预计将减少61%。在艾滋病毒流行最严重的东部和南部非洲，青少年和年轻人中新的艾滋病毒感染人数预计将从2010-2050年下降84%。在艾滋病毒疫情第二大的西非和中非，新感染人数预计将下降35%。结论：虽然青少年和感染艾滋病毒的年轻人寿命更长，进入成年期，但如果目前的趋势继续下去，艾滋病毒新感染人数预计不会以足够快的速度下降，从而结束艾滋病在这个年龄段对健康的威胁。区域差异表明，虽然东部和南部非洲的进展可以在2050年之前减少疫情的规模，但其他区域的青少年和年轻人的下降速度较慢。
Background: Ending AIDS as a public health threat by 2030 is a significant challenge, as new HIV infections among adolescents and young people have not decreased fast enough to curb the epidemic. The combination of slow HIV response and increasing youth populations 15-24 could affect progress towards 2030 goals. Objective: This analysis aimed to describe global and regional trends from 2010-2050 in the HIV epidemic among adolescents and young people by accounting for demographic projections and recent trends in HIV interventions. Methods: 148 national HIV estimates files were used to project the HIV epidemic to 2050. Numbers of people living with HIV and new HIV infections were projected by sex and five-year age group. Along with demographic data, projections were based on three key assumptions: future trends in HIV incidence, antiretroviral treatment coverage, and coverage of antiretrovirals for prevention of mother-to-child transmission. Results represent nine geographic regions. Results: While the number of adolescents and young people is projected to increase by 10% from 2010-2050, those living with HIV is projected to decrease by 61%. In Eastern and Southern Africa, which hosts the largest HIV epidemic, new HIV infections among adolescents and young people are projected to decline by 84% from 2010-2050. In West and Central Africa, which hosts the second-largest HIV epidemic, new infections are projected to decline by 35%. Conclusions: While adolescents and young people living with HIV are living longer and ageing into adulthood, if current trends continue, the number of new HIV infections is not projected to decline fast enough to end AIDS as a health threat in this age group. Regional variations suggest that while progress in Eastern and Southern Africa could reduce the size of the epidemic by 2050, other regions exhibit slower rates of decline among adolescents and young people.