Table 2.
Effect of intervention scenarios on the HIV epidemic outcomes in eSwatini over different time horizons (2010–16, 2016–30, and 2016–50) for adults aged 15–49 years, overall and by sex
| Cumulative incidence reduction | Cumulative mortality reduction | Year | Incidence (per 100 person-years) | Proportion of new cases in 15–24 age group | ||
|---|---|---|---|---|---|---|
| Scenario 1: historical scale-up of ART and VMMC, maintaining 2016 levels (measures relative to scenario 3) | ||||||
| All | ||||||
| 2010–16 | 43·57% (39·71 to 46·36) | 56·17% (54·06 to 58·92) | 2016 | 1·42 (1·12 to 1·71) | 0·39 (0·34 to 0·44) | |
| 2016–30 | 64·81% (61·69 to 67·14) | 89·18% (88·38 to 89·88) | 2030 | 1·09 (0·87 to 1·29) | 0·26 (0·22 to 0·30) | |
| 2016–50 | 70·27% (67·45 to 72·56) | 93·00% (92·37 to 93·52) | 2050 | 0·74 (0·60 to 0·91) | 0·24 (0·19 to 0·29) | |
| Females | ||||||
| 2010–16 | 41·11% (37·44 to 44·59) | 61·22% (58·76 to 63·45) | 2016 | 2·01 (1·54 to 2·49) | 0·48 (0·40 to 0·53) | |
| 2016–30 | 64·18% (61·16 to 66·88) | 92·99% (92·28 to 93·65) | 2030 | 1·42 (1·13 to 1·71) | 0·35 (0·28 to 0·40) | |
| 2016–50 | 70·77% (67·79 to 73·13) | 95·55% (95·17 to 95·93) | 2050 | 0·97 (0·78 to 1·20) | 0·30 (0·23 to 0·35) | |
| Males | ||||||
| 2010–16 | 47·02% (42·41 to 50·20) | 48·94% (45·92 to 52·91) | 2016 | 0·94 (0·72 to 1·16) | 0·25 (0·18 to 0·34) | |
| 2016–30 | 66·97% (63·66 to 68·95) | 83·12% (81·54 to 84·44) | 2030 | 0·79 (0·63 to 0·94) | 0·14 (0·08 to 0·19) | |
| 2016–50 | 71·72% (68·33 to 73·86) | 88·68% (87·55 to 89·64) | 2050 | 0·51 (0·40 to 0·64) | 0·13 (0·08 to 0·18) | |
| Scenario 2: no ART, no VMMC | ||||||
| All | ||||||
| 2010–16 | .. | .. | 2016 | 3·84 (3·03 to 4·65) | 0·36 (0·32 to 0·40) | |
| 2016–30 | .. | .. | 2030 | 4·24 (3·40 to 4·95) | 0·34 (0·29 to 0·38) | |
| 2016–50 | .. | .. | 2050 | 4·46 (3·64 to 5·23) | 0·30 (0·26 to 0·35) | |
| Females | ||||||
| 2010–16 | .. | .. | 2016 | 4·89 (3·91 to 6·11) | 0·45 (0·40 to 0·50) | |
| 2016–30 | .. | .. | 2030 | 5·42 (4·29 to 6·42) | 0·44 (0·38 to 0·50) | |
| 2016–50 | .. | .. | 2050 | 5·81 (4·47 to 7·01) | 0·41 (0·36 to 0·47) | |
| Males | ||||||
| 2010–16 | .. | .. | 2016 | 2·96 (2·39 to 3·55) | 0·24 (0·19 to 0·29) | |
| 2016–30 | .. | .. | 2030 | 3·30 (2·66 to 3·92) | 0·21 (0·17 to 0·26) | |
| 2016–50 | .. | .. | 2050 | 3·55 (2·89 to 4·30) | 0·17 (0·13 to 0·20) | |
| Scenario 3: no ART (VMMC only; measures relative to scenario 2) | ||||||
| All | ||||||
| 2010–16 | 4·56% (1·24 to 8·56) | 0·60% (−2·14 to 3·52) | 2016 | 3·60 (2·88 to 4·27) | 0·35 (0·31 to 0·39) | |
| 2016–30 | 12·26% (9·97 to 16·60) | 4·53% (2·15 to 6·73) | 2030 | 3·41 (2·82 to 3·95) | 0·30 (0·25 to 0·33) | |
| 2016–50 | 20·57% (18·51 to 23·90) | 12·29% (10·44 to 15·23) | 2050 | 3·15 (2·56 to 3·65) | 0·25 (0·22 to 0·29) | |
| Females | ||||||
| 2010–16 | 3·03% (−0·52 to 6·73) | 0·36% (−2·91 to 3·72) | 2016 | 4·66 (3·74 to 5·74) | 0·44 (0·39 to 0·49) | |
| 2016–30 | 9·75% (6·61 to 13·49) | 2·86% (−0·02 to 5·70) | 2030 | 4·54 (3·69 to 5·46) | 0·39 (0·34 to 0·45) | |
| 2016–50 | 17·08% (14·65 to 20·79) | 8·90% (6·92 to 11·87) | 2050 | 4·27 (3·36 to 5·02) | 0·35 (0·30 to 0·40) | |
| Males | ||||||
| 2010–16 | 7·17% (2·78 to 12·12) | 1·06% (−2·33 to 4·91) | 2016 | 2·67 (2·22 to 3·22) | 0·22 (0·17 to 0·28) | |
| 2016–30 | 15·74% (13·26 to 20·43) | 6·92% (3·99 to 9·77) | 2030 | 2·51 (2·10 to 3·03) | 0·16 (0·12 to 0·20) | |
| 2016–50 | 24·64% (22·58 to 27·68) | 16·87% (14·88 to 20·19) | 2050 | 2·36 (1·89 to 2·74) | 0·13 (0·10 to 0·16) | |
| Scenario 4: ART scaled-up to 90-90-90 within each age and sex group (measures relative to scenario 3) | ||||||
| All | ||||||
| 2010–16 | 43·32% (39·49 to 46·46) | 56·76% (53·53 to 59·51) | 2016 | 1·38 (1·14 to 1·72) | 0·39 (0·33 to 0·45) | |
| 2016–30 | 68·54% (65·61 to 71·01) | 91·10% (90·30 to 91·84) | 2030 | 0·97 (0·76 to 1·15) | 0·23 (0·18 to 0·28) | |
| 2016–50 | 73·66% (70·63 to 75·86) | 94·61% (94·05 to 95·09) | 2050 | 0·64 (0·51 to 0·81) | 0·21 (0·16 to 0·26) | |
| Females | ||||||
| 2010–16 | 40·60% (36·47 to 44·63) | 61·63% (58·94 to 64·13) | 2016 | 1·97 (1·56 to 2·52) | 0·47 (0·40 to 0·54) | |
| 2016–30 | 68·20% (65·29 to 71·40) | 93·74% (93·02 to 94·27) | 2030 | 1·25 (0·97 to 1·52) | 0·30 (0·24 to 0·36) | |
| 2016–50 | 74·22% (71·25 to 76·65) | 96·20% (95·79 to 96·57) | 2050 | 0·85 (0·66 to 1·07) | 0·26 (0·19 to 0·32) | |
| Males | ||||||
| 2010–16 | 46·89% (42·16 to 49·96) | 49·47% (44·66 to 53·13) | 2016 | 0·91 (0·73 to 1·14) | 0·25 (0·18 to 0·32) | |
| 2016–30 | 69·74% (66·36 to 72·20) | 86·98% (85·81 to 88·09) | 2030 | 0·71 (0·56 to 0·84) | 0·12 (0·07 to 0·17) | |
| 2016–50 | 74·63% (70·94 to 76·68) | 91·98% (91·20 to 92·73) | 2050 | 0·45 (0·31 to 0·58) | 0·12 (0·06 to 0·18) | |
| Scenario 5: 100% ART initiation among all people living with HIV/AIDS within 6 months, on average, of infection (measures relative to scenario 3) | ||||||
| All | ||||||
| 2010–16 | 43·48% (40·17 to 47·04) | 56·10% (54·11 to 58·76) | 2016 | 1·39 (1·07 to 1·62) | 0·40 (0·34 to 0·46) | |
| 2016–30 | 74·95% (72·23 to 76·84) | 94·52% (94·05 to 94·93) | 2030 | 0·73 (0·55 to 0·92) | 0·21 (0·16 to 0·28) | |
| 2016–50 | 80·13% (77·33 to 81·92) | 97·39% (97·21 to 97·63) | 2050 | 0·46 (0·33 to 0·59) | 0·20 (0·12 to 0·24) | |
| Females | ||||||
| 2010–16 | 41·36% (37·53 to 44·85) | 61·12% (58·67 to 63·25) | 2016 | 1·97 (1·45 to 2·37) | 0·48 (0·41 to 0·53) | |
| 2016–30 | 74·83% (72·39 to 77·01) | 95·91% (95·55 to 96·35) | 2030 | 0·95 (0·68 to 1·18) | 0·28 (0·20 to 0·36) | |
| 2016–50 | 80·48% (77·60 to 82·57) | 98·02% (97·83 to 98·22) | 2050 | 0·60 (0·43 to 0·76) | 0·24 (0·14 to 0·30) | |
| Males | ||||||
| 2010–16 | 47·18% (43·27 to 51·38) | 48·67% (45·89 to 52·58) | 2016 | 0·88 (0·67 to 1·10) | 0·26 (0·19 to 0·34) | |
| 2016–30 | 76·14% (73·18 to 77·69) | 92·26% (91·32 to 92·98) | 2030 | 0·53 (0·37 to 0·73) | 0·10 (0·06 to 0·16) | |
| 2016–50 | 80·86% (78·35 to 82·60) | 96·39% (96·01 to 96·81) | 2050 | 0·32 (0·21 to 0·42) | 0·12 (0·04 to 0·18) | |
Data are median (95% CrI). Cumulative incidence and mortality reductions were calculated as the percent by which incidence or mortality were reduced in each scenario relative to a counterfactual scenario (either the scenario without ART or the scenario without ART or VMMC). Negative values indicate increases in cumulative incidence or mortality. The incidence and proportion of new infections in people aged 15–24 years are shown for the end of each time horizon (ie, the year column). Median and 95% CrIs are reported for 250 of the best fitting parameter sets. ART=antiretroviral therapy. VMMC=voluntary medical male circumcision. CrI=credible interval.