HIV epidemic trend and antiretroviral treatment need in Karonga District, Malawi

• Published in: Epidemiology and infection Vol. 135; no. 6; pp. 922 - 932
• Main Authors: WHITE, R. G., VYNNYCKY, E., GLYNN, J. R., CRAMPIN, A. C., JAHN, A., MWAUNGULU, F., MWANYONGO, O., JABU, H., PHIRI, H., McGRATH, N., ZABA, B., FINE, P. E. M.
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01.08.2007
• Subjects: Adolescent; Adult; Age groups; Aged; AIDS; Anti-Retroviral Agents - therapeutic use; Art periods; Arts; Biological and medical sciences; Communities; Epidemics; Female; Fundamental and applied biological sciences. Psychology; HIV; HIV Infections - drug therapy; HIV Infections - epidemiology; HIV Infections - mortality; Human immunodeficiency virus; Humans; Incidence; Infections; Leprosy; Malawi - epidemiology; Male; Microbiology; Middle Aged; Miscellaneous; Modeling; Models, Biological; Prevalence; Virology; Malawi; Africa; Virus; Epidemic; Antiretroviral agent; Treatment; Retroviridae; Antiviral; Human immunodeficiency virus; Lentivirus
• ISSN: 0950-2688; 1469-4409
• DOI: 10.1017/S0950268806007680

We describe the development of the HIV epidemic in Karonga District, Malawi over 22 years using data from population surveys and community samples. These data are used to estimate the trend in HIV prevalence, incidence and need for antiretroviral treatment (ART) using a simple mathematical model. HIV prevalence rose quickly in the late 1980s and early 1990s, stabilizing at around 12% in the mid-1990s. Estimated annual HIV incidence rose quickly, peaking in the early 1990s at 2·2% among males and 3·1% among females, and then levelled off at 1·3% among males and 1·1% among females by the late 1990s. Assuming a 2-year eligibility period, both our model and the UNAIDS models predicted 2·1% of adults were in need of ART in 2005. This prediction was sensitive to the assumed eligibility period, ranging from 1·6% to 2·6% if the eligibility period was instead assumed to be 1·5 or 2·5 years, respectively.