The evaluation of global epidemic of HIV/AIDS with a novel approach using country-specific counts of HIV infections and three rates controlled for population and geographic area

Abstract

Abstract Background The human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) epidemic is a typical global health concern. The impact of HIV/AIDS is global, and we cannot effectively solve the problem without a global effort. In this study, we report our research on global HIV/AIDS control with an innovative four-dimensional approach. Methods Countries (n = 148) with data available on area size, total population, and the total number of persons living with HIV (PLWH) were included. The HIV epidemic across the globe was described using 4 indicators, including the total count, population-based P rate, geographic area-based G rate, and population and geographic area-based PG rate. Results A total of 35,426,911 PLWH were included, with a global prevalence rate of 0.51 per 1,000 persons. The total PLWH count provided data on resource allocation in individual countries to improve HIV/AIDS care; and the top five countries with the highest PLWH counts were South Africa (7,000), Nigeria (3,500), India (2,100), Kenya (1,500), and Mozambique (1,500). The other three indicators provide a measure to assess the global risk profile of HIV transmission and to provide information on HIV/AIDS prevention strategies. The top five countries with the highest P rates (per 1,000 persons) were Swaziland (170.9), Botswana (154.7), Lesotho (145.2), South Africa (127.4), and Zimbabwe (89.7); the top five countries with the highest G rates (per 100 km2) were Swaziland (1,279.1), Malawi (1,039.5), Lesotho (1,021.1), Rwanda (810.7), and Uganda (748.1); and the top five countries with highest PG rates (per 1,000,000 persons per 100 km2) were Barbados (2,127.9), Swaziland (993.8), Lesotho (478.3), Malta (375.0), and Mauritius (319.7). With PG rate, we detected countries in two hotspots (south and middle Africa and the Caribbean region) and one belt across the Euro-Asian region with high risks of HIV transmission. Conclusions This study expanded the conventional measures by adding two new indicators, thus forming a new four-dimensional framework to quantify the global HIV epidemic. In addition to gaining a better insight into the epidemic than before, study findings provide new data on country-level and global efforts to end the AIDS epidemic by 2030.