Table 1.
Characteristics of the HIV epidemic/ART programme setting‐scenarios in 2017 in SSA countries with an adult population age 15 to 64 years approximately nine million
| Indicator | Median (90% range) across Setting‐scenarios (n = 150) | Examples of observed data |
|---|---|---|
| Population size (in million) | ||
| Overall (15 to 64 years) | 9.1 (8.2 to 9.9) |
Zimbabwe 15 to 64 (2018): 7.8 million 24
Malawi 15 to 64 (2018): 9.8 million 25 Zambia 15 to 64 (2018): 8.2 million 26 Lesotho 15 to 64 (2018): 1.2 million 45 |
| Women (15 to 49 years) | 4.1 (3.8 to 4.3) | |
| Men (15 to 49 years) | 3.9 (3.6 to 4.1) | |
| Young (15 to 24 years) | 3.2 (3.1 to 3.2) | |
| Adult men (25 to 49 years) | 2.3 (2.0 to 2.6) | |
| WTS (15 to 64 years) | 0.16 (0.07 to 0.25) | |
| HIV prevalence | ||
| Overall (15 to 49 years) | 12.8% (4.7% to 27.5%) |
Zimbabwe DHS 2015 10:14% Tanzania DHS 2011 46: 5% Uganda DHS 2011 47: 9% Lesotho DHS 2014 48: 25% |
| Women (15 to 49 years) | 13.0% (4.5% to 29.4%) | |
| Men (15 to 49 years) | 12.6% (5.0% to 23.3%) | |
| Prevalence of undiagnosed HIV | ||
| Overall (15 to 64 years) | 2.1% (0.7% to 4.8%) |
Malawi PHIA 2016 4: 2.9% Zimbabwe PHIA 2016 6: 3.8% Zambia PHIA 2016 5: 4.0% Rwanda 38: approximately 0.3% (Survey estimates could be overestimates due to undisclosed diagnosed HIV 8) |
| Women (15 to 49 years) | 1.2% (0.4% to 3.5%) | |
| Men (15 to 49 years) | 3.3% (1.0% to 7.0%) | |
| HIV incidence (age 15 to 49 years) per 100 person years | 0.91 (0.23 to 2.19) |
Malawi PHIA 2016 4: 0.37% Zimbabwe PHIA 2016 6: 0.45% Zambia PHIA 2016 5: 0.66% Swaziland 7: 2.4% Lesotho 3: 1.5% Mbongolwane and Eshowe published in 2014 (KZN) 49: 1.2% |
| Number of HIV tests in year | ||
| Overall (15 to 64 years) | 2,300,000 (1,293,000 to 3,327,000) | Zimbabwe 2.2 million (2015) 50, Malawi 1.9 million (2014) 51 |
| Women (15 to 49 years) | 1,485,000 (708,000 to 2,271,000) | |
| Men (15 to 49 years) | 796,000 (461,000 to 1,072,000) | |
| ANC services | 721,000 (96,000 to 1,595,000) | |
| WTS (15 to 64 years) | 78,000 (30,000 to 142,000) | |
| Symptomatic (PLHIV)a | 22,000 (8,000 to 47,000) | |
| Symptomatic (HIV–) | 181,000 (160,000 to 200,000) | |
| VMMC services | 150,000 (114,000 to 189,000) | |
| Percentage of tests resulting in new HIV diagnosisb | ||
| Overall (15 to 64 years) | 3.2% (1.1% to 8.3%) |
Observed data estimates are susceptible to bias due to rediagnosis of people who do not report previous diagnosis. 6% to 55% depending on group 52
Malawi first quarter 2016 53: 5% |
| Women (15 to 49 years) | 2.4% (0.7% to 6.3%) | |
| Men (15 to 49 years) | 5.1% (1.6% to 11.3%) | |
| Young (15 to 24 years) | 2.2% (0.4% to 5.7%) | |
| ANC services | 2.9% (0.6% to 17.5%) | |
| WTS (15 to 64 years) | 18.0% (3.3% to 35.1%) | |
| Symptomatic | 9.4% (3.5% to 18.2%) | |
| VMMC services | 3.2% (0.6% to 6.9%) | |
| Proportion tested in past year | ||
| Women (15 to 49 years) | 29% (15% to 41%) |
Zimbabwe DHS 2015 10: 49% women, 36% men (age 15 to 49 years) Namibia DHS 2013 54: 49% women, 38% men (age 15 to 49 years) Nigeria DHS 2013 55: 10% women, 10% men |
| Men (15 to 49 years) | 19% (12% to 27%) | |
| Women (15 to 24 years) | 25% (11% to 38%) | |
| Men (15 to 24 years) | 17% (11% to 23%) | |
| When symptomatic (PLHIV)a , c | 16% (9% to 24%) | |
| In pregnancy (15 to 49 years) | 93% (30% to 98%) | |
| WTS (15 to 64 years) | 39% (22% to 52%) | |
| Proportion of HIV‐positive people diagnosed | ||
| Overall (15 to 64 years) | 83% (73% to 90%) |
Malawi PHIA 2016 4: 73%; 76% in women, 67% in men Zimbabwe PHIA 2016 6: 74% Zambia PHIA 2016 5: 67% Mbongolwane and Eshowe (KZN) published in 2014 49: 75% District of Chiradzulu (rural Malawi) 2013 56: 77% Botswana 2013 to 2015 57: 78%, higher in women than men Survey estimates likely to be over‐estimates due to undisclosed diagnosed HIV 8 |
| Women (15 to 49 years) | 90% (79% to 95%) | |
| Men (15 to 49 years) | 74% (61% to 85%) | |
| Women (15 to 24 years) | 79% (56% to 88%) | |
| Men (15 to 24 years) | 43% (26% to 57%) | |
| WTS (15 to 64 years) | 75% (58% to 87%) | |
| Proportion of diagnosed people on ART | ||
| Overall (15 to 64 years) | 88% (59% to 92%) |
Malawi PHIA 2016 4: 89% Zimbabwe PHIA 2016 6: 87% Zambia PHIA 2016 5: 85% Botswana 2013 to 15 57: 85% |
| Women (15 to 49 years) | 89% (59% to 92%) | |
| Men (15 to 49 years) | 87% (56% to 91%) | |
| Women (15 to 24 years) | 89% (42% to 93%) | |
| Men (15 to 24 years) | 79% (33% to 91%) | |
| WTS (15 to 64 years) | 90% (50% to 94%) | |
| Proportion of people on ART with VL < 1000 copies/mL | ||
| Overall (15 to 64 years) | 85% (81% to 89%) |
World Bank South Africa 58: 60% to 88% over districts Malawi PHIA 2016 4: 91% Zimbabwe PHIA 2016 6: 87% Zambia PHIA 2016 5: 89% District of Chiradzulu (rural Malawi) 2013 56: 91% Mbongolwane and Eshowe (KZN) published in 2014 49: 90% Rural Uganda and Kenya 59: 90% Botswana 2013 to 2015 57: 94% (among citizens of Botswana) |
ANC, antenatal care; ART, antiretroviral therapy; DHS, Demographic and Health Surveys; KZN, KwaZulu‐Natal; PHIA, Population‐based HIV Impact Assessment; PLHIV, people living with HIV; VMMC, voluntary male medical circumcision; WTS, women having transactional sex.
aSymptoms of a WHO Stage 3 or 4 condition; bThis is also referred to as yield. In our model, this is the same as test positivity rate as within the Synthesis model people who received a diagnosis of HIV cannot test again, so this is the ratio between the number of new diagnoses and the number of tests performed; cin this case is not in the past year but of those symptomatic/pregnant in a specific time period.