TRIPS, Public Health Systems and Free Access
Edited by Benjamin Coriat
Chapter 8: HIV Prevalence Estimates: The New Deal in Sub-Saharan Africa Since 2000
8. HIV prevalence estimates: the new deal in Sub-Saharan Africa since 2000 Joseph Larmarange HIV prevalence and incidence data are necessary at diﬀerent levels, for monitoring the epidemics, understanding their dynamics, determining priorities of actions, modelling AIDS impact on population and so on. In macro-economy, HIV prevalence is often an important parameter of the models. HIV prevalence data are often used for evaluation, planning and advocacy and so their uses are very political. Since 2000, changes in UNAIDS estimates have reﬂected improvements in the methodology used. For example, the estimated number of persons living with HIV worldwide in 2007 was 33.2 million (30.6–36.1 million) (UNAIDS, 2007), a reduction of 16 per cent compared with the estimate published in 2006 (39.5 million (34.7–47.1 million)) (UNAIDS, 2006). This diﬀerence is largely due to more accurate data and assumptions about HIV epidemics. So, UNAIDS estimates from diﬀerent reports cannot be directly compared and apparent trends do not reﬂect HIV epidemic trends. This chapter will review and discuss the diﬀerent sources of HIV data and the estimation methodology used. BRIEF HISTORY OF HIV SURVEILLANCE Initially, sentinel surveillance of speciﬁc populations was developed in SubSaharan Africa in the 1980s to identify the emergence and spread of HIV epidemics. Nationally representative seroprevalence surveys have not generally been conducted,1 largely due to cost concerns. So eﬀorts were focused on the surveillance of speciﬁc populations, this system becoming generalized in Sub-Saharan Africa in the 1990s. The...
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