AEGiS-08IAC: AIDS in the world 1992--estimating HIV/AIDS morbidity and mortality since the beginning of the pandemic.

8th International AIDS Conference

Amsterdam, Netherlands — July 19-24, 1992

AIDS in the world 1992--estimating HIV/AIDS morbidity and mortality since the beginning of the pandemic.

Int Conf AIDS 1992 Jul 19-24; 8:We62 (abstract no. WeC 1093)
Mantel C, Tarantola D, Lepisto E, Jain N, Shahi G, Mann JM; Global AIDS Policy Coalition, International AIDS Center, Harvard School of Public Health, Boston.

OBJECTIVES: The reported number of persons with AIDS gives an incomplete picture of the global situation. We used a simple multi-stage modeling approach to better determine the dynamics of the pandemic.

METHODS: (1) From a Delphi survey, estimates of AIDS reporting efficiency were produced in each of ten defined regions in the world and crude corrections for the reporting delays were made. This provided adjusted AIDS incidence figures for the period 1984-1991. (2) From a review of all available recent seroprevalence data for antenatal women, blood donors and commercial sex workers, a current number of HIV infected persons was computed for each region. Adjustment was made for type of sentinel group and gender and urban/rural differences in HIV prevalence. (3) Adult HIV incidence and prevalence curves were modeled independently for each region using a gamma-distribution (EPIMODEL software). The model was simultaneously adjusted to fit the AIDS incidence curve derived previously, incorporating differential rates of progression from HIV to AIDS. The adult AIDS mortality distribution was generated, and the number of children with AIDS, the pediatric HIV incidence and pediatric AIDS mortality were calculated.

RESULTS: It was estimated that the cumulative global number of adults with AIDS was between 1.6 and 1.9 million in early 1992. About 63% were from Sub-Saharan Africa, 15% from North America and 11% from Latin America and the Caribbean. Up to 11 million adults have been infected with HIV since the beginning of the pandemic. More than 500,000 children are estimated to have developed AIDS and subsequently died. The overall number of adult deaths from AIDS is thought to have reached 1.5 million. Projections based on refined models were made for the years 1995 and 2000.

CONCLUSIONS: The projections derived from Delphi-adjusted AIDS incidence estimates combined with data from HIV serosurveys indicate that the pandemic will continue to expand during the 90's with: (a) further spread in areas which already experienced high HIV/AIDS incidence in the 80's; and (b) a rapid progression in areas where incidence so far had remained low. Global and regional estimates will be regularly updated and published in "AIDS in the World".

Keywords: AEGIS, Acquired Immunodeficiency Syndrome, HIV, HIV Infections, Incidence, HIV Seroprevalence, Prevalence, Forecasting, Demography, HIV-1, Receptors, HIV, Seroepidemiologic Studies, Africa South of the Sahara, North America, Latin America, Caribbean Region, Human, Female, Adult, Child, mortality, epidemiology, ICA8
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