Table 1.
HIV incidence estimates among young women and men in samples representing the general population
| Country | Location, region, or setting | Study design (measure of HIV incidence) | Year |
HIV incidence per 100 PYs (95% CIs)* |
||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Females |
Males |
|||||||||
| Age 15–19 years | Age 20–24 years | Age 25–30 years | Age 15–19 years | Age 20–24 years | Age 25–30 years | |||||
| Birdthistle et al (2018)19 and Borgdorff et al (2018)20 | Kenya | Gem subcounty, Siaya county | Prospective cohort (direct estimates) | 2011–16 | 0·43 (2·96–5·91); n=35;PYs=8236 | 1·12 (0·80–1·52); n=40; PYs=3574 | 0·96 (0·73–1·25)†; n=56; PYs=5800 | 0·32 (0·19–0·51); n=17;PYs=5300 | Included in previous estimate | 1·07 (0·71–1·57)†; n=27;PYs=2500 |
| Blaizot et al (2017)21 | Kenya | Ndhiwaza subcounty, Siaya county (former province of Nyanza) | Cross-sectional survey (test for recent infection; estimates from assay measurements) | 2012 | BioRad avidity assay: 2·07 (0·85–3·29); n=18; N=184; limiting antigen avidity enzyme immunoassay 2·50 (1·10–4·50); n=11; N=184 | Included in previous estimate | BioRad avidity assay: 1·90 (0·00–3·90)†; n=16; N=359; limiting antigen avidity enzyme immunoassay: 2·40 (0·20–5·10)†; n=8; N=359 | BioRad avidity assay: 0·25 (0·00–0·73); n=2; N=25; limiting antigen avidity enzyme immunoassay: 0·30 (0·00–2·70); n=1; N=25 | Included in previous estimate | BioRad avidity assay: 2·50 (0·20–4·60)†; n=9; N=121; limiting antigen avidity enzyme immunoassay: 0·96 (0·00–2·79)†; n=2; N=121 |
| Malawi Ministry of Health (2017)22 | Malawi | National | Cross-sectional (test for recent infection) | 2015–16 | 0·40(0·04–0·77) | Included in previous estimate | 0·87 (0·11–1·63)† | 0·05(0·00–0·19) | Included in previous estimate | 0·40 (0·00–0·91)† |
| Vandormael et al (2014)23 | South Africa | uMkhanyakude district, KwaZulu-Natal | Prospective cohort (direct estimates) | 2004–12 | 4·91 (4·48–5·39); n=451; PYs=9179 | 7·80 (7·19–8·46); n=583; PYs=7478 | 6·50 (5·66–7·45)‡; n=204; PYs=3140 | 0·90 (0·71–1·12); n=75; PYs=8373 | 3·28 (2·85–3·78); n=192; PYs=5848 | 4·66 (3·82–5·68)‡; n=97; PYs=2082 |
| Harling et al (2014)24 | South Africa | uMkhanyakude district, KwaZulu-Natal (sexually active) | Prospective cohort (direct estimates) | 2003–12 | 7·79 (6·59–9·22) | 8·63 (7·63–9·77); n=458; PYs=5913 | 5·63 (4·46–7·11)‡ | ·· | ·· | ·· |
| Rosenberg et al (2013)25 | South Africa | uMkhanyakude district, KwaZulu-Natal | Prospective cohort (direct estimates) | 2006–11 | 4·37 (3·79–5·04); n=190; PYs=4344 | Included in previous estimate | ·· | 1·38(1·07–1·79); n=58; PYs=4193 | Included in previous estimate | ·· |
| Tanser et al (2011)26 | South Africa | uMkhanyakude district, KwaZulu-Natal | Prospective cohort (direct estimates) | 2004–09 | 5·10 (4·58–5·67); n=342; PYs=6701·51 | 7·47 (6·33–8·76); n=152; PYs=2033·72 | 5·18 (3·88–6·77)‡; n=53; PYs=1023·38 | ·· | ·· | ·· |
| Tanser et al (2013)27 | South Africa | uMkhanyakude district, KwaZulu-Natal | Prospective cohort (direct estimates) | 2004–11 | 4·43 (3·96–4·95); n=312; PYs=7036 | 6·49 (5·86–7·18); n=375; PYs=5776 | 5·51 (4·64–6·54)‡; n=131; PYs=2376 | 0·74 (0·56–0·99); n=48; PYs=6458 | 2·53 (2·10–3·05); n=109; PYs=4310 | 4·43 (3·50–5·61)‡; n=69; PYs=1557 |
| Dobra et al (2017)3 | South Africa | uMkhanyakude district, KwaZulu-Natal | Prospective cohort (direct estimates) | 2004–14 | 5·10 (4·61–5·60); n=388; PYs=7604 | 9·11 (8·40–9·82); n=570; PYs=6257 | 7·03 (6·07–7·99)‡; n=192; PYs=2732 | 0·91 (0·70–1·12); n=72;PYs=7908 | 3·69 (3·19–4·19); n=203; PYs=5504 | 5·79 (4·79–6·80)‡; n=121; PYs=2088 |
| Akullian et al (2017)28 | South Africa | uMkhanyakude district, KwaZulu-Natal | Prospective cohort (direct estimates) | 2004–15 | 5·6(5·3–5·9); n=1173;PYs=21 043 | Included in previous estimate | 3·1(2·9–3·4)§; n=615;PYs=19 863 | 1·7(1·5–1·9); n=296;PYs=17 915 | Included in previous estimate | 3·6 (3·1–4·2)†; n=184; PYs=5061 |
| Chimbindi et al (2018)29 | South Africa | uMkhanyakude district, KwaZulu-Natal | Prospective cohort (direct estimates) | 2006–10 | 4·71(4·10–5·41); n=254; PYs=5395 | 7·62 (6·71–8·65); n=340; PYs=4462 | ·· | ·· | ·· | ·· |
| Chimbindi et al (2018)29 | South Africa | uMkhanyakude district, KwaZulu-Natal | Prospective cohort (direct estimates) | 2011–15 | 4·54 (3·89–5·30); n=197; PYs=4330 | 7·45 (6·51–8·51); n=289; PYs=3881 | ·· | ·· | ·· | ·· |
| Baisley et al (2018)30 | South Africa | uMkhanyakude district, KwaZulu-Natal | Prospective cohort (direct estimates) | 2006–10 | ·· | ·· | ·· | ·· | 3·08 (2·49–3·82); n=120; PYs=3897 | 4·43 (3·34–5·87)‡; n=68; PYs=1530 |
| Baisley et al (2018)30 | South Africa | uMkhanyakude district, KwaZulu-Natal | Prospective cohort (direct estimates) | 2011–15 | ·· | ·· | ·· | ·· | 2·58 (2·00–3·32); n=81; PYs=3121 | 4·04 (3·07–5·31)‡; n=73; PYs=1793 |
| Bärnighausen et al (2008)31¶ | South Africa | uMkhanyakude district, KwaZulu-Natal | Prospective cohort (direct estimates) | 2003–07 | 3·9(2·9–5·3) | 5·6(4·0–8·0) | 8·0(4·9–13·0)‡ | 1·0(0·5–1·8) | 2·8(1·6–4·8) | 8·7(4·8–15·8)‡ |
| Unpublished data from Iwuji et al (2018)32 | South Africa | uMkhanyakude district (Hlabisa subdistrict), KwaZulu-Natal | Intervention (direct estimates; control arm) | 2012–15 | 5·54 (4·64–6·45)‖; n=144; PYs=2597 | 6·93(5·75–8·11); n=133; PYs=1919 | 6·34 (4·77–7·90)‡; n=63; PYs=994 | 0·61 (0·28–0·94)‖; n=13; PYs=2144 | 2·02 (1·19–2·84); n=23; PYs=1141 | 1·06 (0·21–1·90)‡; n=6; PYs=567 |
| Shisana et al (2005)33 | South Africa | National | Cross-sectional (test for recent infection; estimates from assay measurements) | 2005 | 6·5 (2·3–10·7); n=61; N=2335 | Included in previous estimate | 7·1 (2·6–11·6)†; n=48; N=2013 (for men and women combined) | 0·8 (0·0–3·4); n=9; N=1785 | Included in previous estimate | 7·1 (2·6–11·6)†; n=48; N=2013 (for men and women combined) |
| Shisana et al (2014)7 | South Africa | National | Cross-sectional (test for recent infection; estimates from assay measurements) | 2012 | 2·54 (2·04–3·04); N=3092 | Included in previous estimate | 1·62 (1·30–1·94)**; N=8857 | 0·55 (0·45–0·65); N=2798 | Included in previous estimate | 1·29 (0·91–1·67)**; N=5959 |
| Justman et al (2017)6†† | Swaziland | National | Prospective cohort (direct estimates) | 2010–11 | 3·8 (2·6–5·6)‡‡; n=16·0; PYs=421·1 | 4·3 (3·3–5·6); n=36·4; PYs=846·5 | 2·0 (1·2–3·2)‡; n=10·2; PYs=510 | 0·8 (0·4–1·9)‡‡;n=4·0;PYs=500 | 1·6 (1·1–2·5); n=16·0; PYs=1000 | 2·6 (1·7–4·0)‡; n=16·9; PYs=650 |
| Unpublished data from Geis et al (2011)34§§ | Tanzania | Mbeya | Prospective cohort (direct estimates) | 2005–06 | 0¶¶ | 2·60(1·51–4·47) | 0·26 (0·04–1·84)‡ | 0¶¶ | 1·36 (0·57–3·27) | 0·72 (0·18–2·88)‡ |
| Okiria et al (2014)35††‖‖ | Uganda | Kumi district (rural) | Prospective cohort (direct estimates) | 2006–08 | 0·38 (0·19–0·66)***; n=11; PYs=2894·7 | ·· | 0·68 (0·44–1·01)‡; n=25; PYs=3676·5 | 0·26 (0·07–0·66)***; n=4; PYs=1538·5 | ·· | 0·28 (0·09–0·65)‡; n=5; PYs=1785·7 |
| Biraro et al (2013)36†† | Uganda | Masaka | Prospective cohort (direct estimates) | 1990–2007 | 0·57 (0·44–0·74)***; n=58; PYs=10 104 | 1·19 (0·91–1·53); n=59; PYs=4962 | 0·95 (0·68–1·30)‡; n=39; PYs=4108 | 0·09 (0·04–0·16)***; n=10; PYs=11 261 | 0·79 (0·55–1·09); n=36; PYs=4554 | 1·35 (0·99–1·80)‡; n=46; PYs=3415 |
| Unpublished data from Grabowski et al (2017)37 | Uganda | Rakai | Prospective cohort (direct estimates) | 2005–11 | 1·03 (0·64–1·57); n=19; PYs=1840 | 1·47 (1·12–1·90); n=55; PYs=3730 | 1·47 (1·15–1·84)‡; n=70; PYs=4772 | 0·30 (0·12–0·60); n=6; PYs=2023 | 0·90 (0·61–1·28); n=28; PYs=3107 | 1·73 (1·31–2·23)‡; n=55; PYs=3173 |
| Unpublished data from Grabowski et al (2017)37 | Uganda | Rakai | Prospective cohort (direct estimates) | 2011–16 | 0·59(0·31–1·01); n=11; PYs=1857 | 1·53(1·13–2·01); n=47; PYs=3077 | 1·12 (0·81–1·50)‡; n=41; PYs=3664 | 0·16 (0·05–0·38); n=4; PYs=2466 | 0·40 (0·21–0·68); n=12; PYs=2973 | 1·26 (0·89–1·72)‡; n=55; PYs=2783 |
| Santelli et al (2013)38 | Uganda | Rakai (sexually experienced) | Prospective cohort (direct estimates) | 1998–2008 | 1·49 (1·06–2·04); n=39; PYs=2614 | 1·38 (1·13–1·66); n=109; PYs=7907 | ·· | 0·36 (0·14–0·73); n=7; PYs=1969 | 1·02 (0·76–1·35); n=49; PYs=4803 | ·· |
| Santelli et al (2015)39†† | Uganda | Rakai (sexually experienced) | Prospective cohort (direct estimates) | 2006–09 | 0·63 (0·20–1·47); n=5; PYs=793·7 | 1·31 (0·82–1·98); n=22; PYs=1679·4 | ·· | 0·22 (0·03–0·79); n=2; PYs=909·1 | 0·79 (0·38–1·45); n=10; PYs=1265·8 | ·· |
| Santelli et al (2015)39†† | Uganda | Rakai (sexually experienced) | Prospective cohort (direct estimates) | 2008–11 | 0·23 (0·03–0·83); n=2;PYs=869·6 | 1·55(0·95–2·39); n=20; PYs=1290·3 | ·· | 0·19 (0·02–0·69); n=2; PYs=1052·6 | 1·23 (0·69–2·03); n=15; PYs=1219·5 | ·· |
| Unpublished data from Ruzagira et al (2011)14 | Uganda | Masaka | Prospective cohort (direct estimates) | 2004–07 | 0;n=0; PYs=64·1 | 0;n=0; PYs=206·8 | 2·0(0·8–4·8)‡; n=5; PYs=252·1 | 0;n=0;PYs=26 | 2·5(0·8–7·7); n=3; PYs=121·4 | 2·2(0·7–6·8)‡; n=3;PYs=139·5 |
| Zambia Ministry of Health (2017)40 | Zambia | National | Cross-sectional (test for recent infection; estimates from assay measurements) | 2015–16 | 1·07(0·52–1·62) | Included in previous estimate | 1·16 (0·46–1·86)† | 0·08 (0·00–0·25) | Included in previous estimate | 0·25 (0·00–0·63)† |
| Unpublished data from Schaefer et al (2017)41 | Zimbabwe | Manicaland | Prospective cohort (direct estimates) | 2003–13 | 0·99 (0·71–1·38); n=35; PYs=3530·20 | 1·62 (1·26–2·08); n=62; PYs=3830·1 | 1·45 (1·12–1·88)‡; n=57; PYs=3930·9 | 0·26 (0·15–0·46); n=12; PYs=4557·3 | 0·83 (0·55–1·26); n=22; PYs=2642·3 | 1·47 (1·04–2·06)‡; n=22; PYs=2250·2 |
| Unpublished data from Schaefer et al (2017)41 | Zimbabwe | Manicaland | Prospective cohort (direct estimates) | 2004–08 | 1·94(1·50–2·51); n=59; PYs=3039·8 | Included in previous estimate | ·· | 0·93 (0·64–1·36); n=27; PYs=3895·0 | Included in previous estimate | ·· |
| Unpublished data from Schaefer et al (2017)41 | Zimbabwe | Manicaland | Prospective cohort (direct estimates) | 2006–11 | 0·72 (0·46–1·14); n=19; PYs=2625·4 | Included in previous estimate | ·· | 0·15 (0·06–0·39); n=4; PYs=2740·5 | Included in previous estimate | ·· |
| Unpublished data from Schaefer et al (2017)41 | Zimbabwe | Manicaland | Prospective cohort (direct estimates) | 2009–13 | 1·12(0·72–1·76); n=19; PYs=1695·0 | Included in previous estimate | ·· | 0·19 (0·06–0·60); n=3; PYs=1564·2 | Included in previous estimate | ·· |
| Zimbabwe MOHCC (2017)42 | Zimbabwe | National | Cross-sectional (test for recent infection; estimates from assay measurements) | 2015–16 | 0·53(0·13–0·93) | Included in previous estimate | 1·11 (0·41–1·80)† | 0·14 (0·00–0·37) | Included in previous estimate | 0·48 (0·00–1·05)† |
PYs=person-years. Included in previous estimate=data for age groups 15–19 years and 20–24 years are combined into one estimate (as given in adjacent cell). MOHCC=Ministry of Health and Child Care.
*
Cases (n) and PYs are shown when available. Total sample size (N) is given when PYs were not available.
†
Up to age 34 years.
‡
Up to age 29 years.
§
Up to age 49 years.
¶
n=170; PYs=5253 for all men and women aged 15–34 years.
‖
Between ages 16 years and 19 years.
**
Older than 25 years.
††
PYs or 95% CIs, or both, were calculated from data in study; CIs were calculated using exact Poisson CIs.
‡‡
Between ages 18 years and 19 years.
§§
n=101; PYs=7471 for study incorporating data from 2003 to 2004 (not included here) and 2005 to 2006 (included here).
¶¶
Between ages 17 years and 19 years.
‖‖
Data from a home-based HIV counselling and testing programme offered community wide.
***
Between ages 13 years and 19 years.