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Assessment of epidemic projections using recent HIV survey data in South Africa: a validation analysis of ten mathematical models of HIV epidemiology in the antiretroviral therapy era

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dc.date.accessioned 2015-09-25 en
dc.date.accessioned 2021-02-09T15:23:09Z
dc.date.available 2021-02-09T15:23:09Z
dc.date.issued 2015-09-25 en
dc.identifier.uri http://hdl.handle.net/20.500.11910/1787
dc.description.abstract Mathematical models are widely used to simulate the effects of interventions to control HIV and to project future epidemiological trends and resource needs. We aimed to validate past model projections against data from a large household survey done in South Africa in 2012. The authors compared ten model projections of HIV prevalence, HIV incidence, and antiretroviral therapy (ART) coverage for South Africa with estimates from national household survey data from 2012. Model projections for 2012 were made before the publication of the 2012 household survey. We compared adult (age 15-49 years) HIV prevalence in 2012, the change in prevalence between 2008 and 2012, and prevalence, incidence, and ART coverage by sex and by age groups between model projections and the 2012 household survey. All models projected lower prevalence estimates for 2012 than the survey estimate (18.8%), with eight models' central projections being below the survey 95% CI (17.5-20.3). Eight models projected that HIV prevalence would remain unchanged (n=5) or decline (n=3) between 2008 and 2012, whereas prevalence estimates from the household surveys increased from 16.9% in 2008 to 18.8% in 2012 (difference 1.9, 95% CI-0.1 to 3.9). Model projections accurately predicted the 1.6 percentage point prevalence decline (95% CI - 0.3 to 3.5) in young adults aged 15-24 years, and the 2.2 percentage point (0.5 to 3.9) increase in those aged 50 years and older. Models accurately represented the number of adults on ART in 2012; six of ten models were within the survey 95% CI of 1.54-2.12 million. However, the differential ART coverage between women and men was not fully captured; all model projections of the sex ratio of women to men on ART were lower than the survey estimate of 2?22 (95% CI 1.73-2.71). Projections for overall declines in HIV epidemics during the ART era might have been optimistic. Future treatment and HIV prevention needs might be greater than previously forecasted. Additional data about service provision for HIV care could help inform more accurate projections. en
dc.format.medium Print en
dc.publisher Elsevier en
dc.subject HIV/AIDS en
dc.subject EPIDEMIOLOGY en
dc.subject ANTIRETROVIRAL THERAPY en
dc.title Assessment of epidemic projections using recent HIV survey data in South Africa: a validation analysis of ten mathematical models of HIV epidemiology in the antiretroviral therapy era en
dc.type Journal Article en
dc.description.version Y en
dc.ProjectNumber N/A en
dc.Volume 3 en
dc.BudgetYear 2015/16 en
dc.ResearchGroup HIV/AIDS, STIs and TB en
dc.SourceTitle The Lancet en
dc.PlaceOfPublication New York, USA en
dc.ArchiveNumber 8816 en
dc.URL http://ktree.hsrc.ac.za/doc_read_all.php?docid=15745 en
dc.PageNumber 598-608 en
dc.outputnumber 7568 en
dc.bibliographictitle Eaton, J.W., Bacaer, N., Bershteyn, A., Cambiano, V., Cori, A., Dorrington, R.E., Fraser, C., Gopalappa, C., Hontelez, J.A.C., Johnson, L.F., Klein, D.J., Phillips, A.N., Pretorius, C., Stover, J., Rehle, T.M. & Hallett, T.B. (2015) Assessment of epidemic projections using recent HIV survey data in South Africa: a validation analysis of ten mathematical models of HIV epidemiology in the antiretroviral therapy era. <i>The Lancet</i>. 3:598-608. http://hdl.handle.net/20.500.11910/1787 en
dc.publicationyear 2015 en
dc.contributor.author1 Eaton, J.W. en
dc.contributor.author2 Bacaer, N. en
dc.contributor.author3 Bershteyn, A. en
dc.contributor.author4 Cambiano, V. en
dc.contributor.author5 Cori, A. en
dc.contributor.author6 Dorrington, R.E. en
dc.contributor.author7 Fraser, C. en
dc.contributor.author8 Gopalappa, C. en
dc.contributor.author9 Hontelez, J.A.C. en
dc.contributor.author10 Johnson, L.F. en
dc.contributor.author11 Klein, D.J. en
dc.contributor.author12 Phillips, A.N. en
dc.contributor.author13 Pretorius, C. en
dc.contributor.author14 Stover, J. en
dc.contributor.author15 Rehle, T.M. en
dc.contributor.author16 Hallett, T.B. en


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