Imperial College London
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DrLouisaMoorhouse

Faculty of Medicine, School of Public Health

Research Associate
 
 
 
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l.moorhouse

 
 
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Location

 

School of Public HealthWhite City Campus

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Summary

 

Publications

Citation

BibTex format

@article{Risher:2021:10.1016/S2352-3018(21)00069-2,
author = {Risher, K and Cori, A and Reniers, G and Marston, M and Calvert, C and Crampin, A and Dadirai, T and Dube, A and Gregson, S and Herbst, K and Lutalo, T and Moorhouse, L and Mtenga, B and Nabukalu, D and Newton, R and Price, AJ and Tlhajoane, M and Todd, J and Tomlin, K and Urassa, M and Vandormael, A and Fraser, C and Slaymaker, E and Eaton, J},
doi = {10.1016/S2352-3018(21)00069-2},
journal = {The Lancet HIV},
pages = {e429--e439},
title = {Age patterns of HIV incidence in eastern and southern Africa: a collaborative analysis of observational general population cohort studies},
url = {http://dx.doi.org/10.1016/S2352-3018(21)00069-2},
volume = {8},
year = {2021}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background: As the HIV epidemic in sub-Saharan Africa matures, evidence about the age distribution of new HIV infections and how this has changed over the epidemic is needed to guide HIV prevention. We assessed trends in age-specific HIV incidence in six population-based cohort studies in eastern and southern Africa, reporting changes in average age at infection, age distribution of new infections, and birth cohort cumulative incidence. Methods: We used a Bayesian model to reconstruct age-specific HIV incidence from repeated observations of individuals’ HIV serostatus and survival collected among population HIV cohorts in rural Malawi, South Africa, Tanzania, Uganda, and Zimbabwe. The HIV incidence rate by age, time and sex was modelled using smooth splines functions. Incidence trends were estimated separately by sex and study. Estimated incidence and prevalence results for 2000-2017, standardised to study population distribution, were used to estimate average age at infection and proportion of new infections by age. Findings: Age-specific incidence declined at all ages, though the timing and pattern of decline varied by study. The average age at infection was higher in men (cohort means: 27·8-34·6 years) than women (cohort means: 24·8-29·6 years). Between 2000 and 2017, the average age at infection increased slightly: cohort means 0·5-2·8 years among men and -0·2-2·5 years among women. Across studies, between 38-63%(cohort means)of women’s infections were among 15-24-year-olds and between 30-63% of men’s infections were in 20-29-year-olds. Lifetime risk of HIV declined for successive birth cohorts. Interpretation: HIV incidence declined in all age groups and shifted slightly, but not dramatically, to older ages. Disproportionate new HIV infections occur among 15-24-year-old 4women and20-29-year-oldmen, supporting focused prevention in these groups. But 40-60% of infections were outside these
AU  - Risher,K
AU  - Cori,A
AU  - Reniers,G
AU  - Marston,M
AU  - Calvert,C
AU  - Crampin,A
AU  - Dadirai,T
AU  - Dube,A
AU  - Gregson,S
AU  - Herbst,K
AU  - Lutalo,T
AU  - Moorhouse,L
AU  - Mtenga,B
AU  - Nabukalu,D
AU  - Newton,R
AU  - Price,AJ
AU  - Tlhajoane,M
AU  - Todd,J
AU  - Tomlin,K
AU  - Urassa,M
AU  - Vandormael,A
AU  - Fraser,C
AU  - Slaymaker,E
AU  - Eaton,J
DO  - 10.1016/S2352-3018(21)00069-2
EP  - 439
PY  - 2021///
SN  - 2405-4704
SP  - 429
TI  - Age patterns of HIV incidence in eastern and southern Africa: a collaborative analysis of observational general population cohort studies
T2  - The Lancet HIV
UR  - http://dx.doi.org/10.1016/S2352-3018(21)00069-2
UR  - https://www.sciencedirect.com/science/article/pii/S2352301821000692?via%3Dihub
UR  - http://hdl.handle.net/10044/1/89058
VL  - 8
ER  -
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