Khalifa A, Stover J, Mahy M, Idele P, Porth T, Lwamba C. Demographic change and HIV epidemic projections to 2050 for adolescents and young people aged 15-24.
Glob Health Action 2020;
12:1662685. [PMID:
31510887 PMCID:
PMC6746261 DOI:
10.1080/16549716.2019.1662685]
[Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
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.
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