Revealing geographical and population heterogeneity in HIV incidence, undiagnosed hiv prevalence and time to diagnosis to improve prevention and care : Estimates for France

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dc.contributor.authorHERMETIC Study Group
dc.contributor.authorĶīvīte, Anda
dc.contributor.institutionRīga Stradiņš University
dc.date.accessioned2021-06-14T09:15:01Z
dc.date.available2021-06-14T09:15:01Z
dc.date.issued2018-03
dc.descriptionFunding Information: LM, DC and VS thank INSEE and Réeseau Quetelet for kindly providing national and subnational statistics on population size (Donnéees harmoniséees des recensements de la population: Tabulation sur mesure, INSEE [producteur], ADISP-CMH [diffuseur]). LM, DC and VS also thank Christophe Godéereaux for optimizing the code written in C and Eric Janssen (OFDT) for sharing his estimates on drug use in France before publication as well as providing additional estimates. This work was supported by ANRS throughout the project ANRS 95017 INDIC and the framework of HIVERA JTC 2014. The sponsor had no role in the study. Publisher Copyright: © 2018 The Authors.
dc.description.abstractTo close gaps in HIV prevention and care, knowledge about locations and populations most affected by HIV is essential. Here, we provide subnational and sub-population estimates of three key HIV epidemiological indicators, which have been unavailable for most settings. Methods: We used surveillance data on newly diagnosed HIV cases from 2004 to 2014 and back-calculation modelling to estimate in France, at national and subnational levels, by exposure group and country of birth: the numbers of new HIV infections, the times to diagnosis, the numbers of undiagnosed HIV infections. The denominators used for rate calculations at national and subnational levels were based on population size (aged 18 to 64) estimates produced by the French National Institute of Statistics and Economic Studies and the latest national surveys on sexual behaviour and drug use. Results: We estimated that, in 2014, national HIV incidence was 0.17& (95% confidence intervals (CI): 0.16 to 0.18) or 6607 (95% CI: 6057 to 7196) adults, undiagnosed HIV prevalence was 0.64& (95% CI: 0.57 to 0.70) or 24,197 (95% CI: 22,296 to 25,944) adults and median time to diagnosis over the 2011 to 2014 period was 3.3 years (interquartile range: 1.2 to 5.7). Three mainland regions, including the Paris region, out of the 27 French regions accounted for 56% of the total number of new and undiagnosed infections. Incidence and undiagnosed prevalence rates were 2-to 10-fold higher than the national rates in three overseas regions and in the Paris region (p-values < 0.001). Rates of incidence and undiagnosed prevalence were higher than the national rates for the following populations (p-values < 0.001): born-abroad men who have sex with men (MSM) (respectively, 108-and 78-fold), French-born MSM (62-and 44-fold), born-abroad persons who inject drugs (14-and 18-fold), sub-Saharan African-born heterosexuals (women 15-and 15-fold, men 11-and 13-fold). Importantly, affected populations varied from one region to another, and in regions apparently less impacted by HIV, some populations could be as impacted as those living in most impacted regions. Conclusions: In France, some regions and populations have been most impacted by HIV. Subnational and sub-population estimates of key indicators are not only essential to adapt, design implement and evaluate tailored HIV interventions in France, but also elsewhere where similar heterogeneity is likely to exist.en
dc.description.statusPeer reviewed
dc.format.extent426300
dc.identifier.citationHERMETIC Study Group & Ķīvīte, A 2018, 'Revealing geographical and population heterogeneity in HIV incidence, undiagnosed hiv prevalence and time to diagnosis to improve prevention and care : Estimates for France', Journal of the International AIDS Society, vol. 21, no. 3, e25100. https://doi.org/10.1002/jia2.25100
dc.identifier.doi10.1002/jia2.25100
dc.identifier.issn1758-2652
dc.identifier.urihttps://dspace.rsu.lv/jspui/handle/123456789/4959
dc.identifier.urlhttp://www.scopus.com/inward/record.url?scp=85051019363&partnerID=8YFLogxK
dc.language.isoeng
dc.relation.ispartofJournal of the International AIDS Society
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectExposure group
dc.subjectGeographical analysis
dc.subjectHiv incidence
dc.subjectMap
dc.subjectModelling
dc.subjectSubnational and sub-population estimates
dc.subjectTime to HIV diagnosis
dc.subjectUndiagnosed hiv prevalence
dc.subject3.2 Clinical medicine
dc.subject1.1. Scientific article indexed in Web of Science and/or Scopus database
dc.subjectPublic Health, Environmental and Occupational Health
dc.subjectInfectious Diseases
dc.subjectSDG 3 - Good Health and Well-being
dc.titleRevealing geographical and population heterogeneity in HIV incidence, undiagnosed hiv prevalence and time to diagnosis to improve prevention and care : Estimates for Franceen
dc.type/dk/atira/pure/researchoutput/researchoutputtypes/contributiontojournal/article

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