Growing gender disparity in HIV infection in Africa: sources and policy implications
Ssekasanvu Joseph 1Ratmann Oliver 2Golubchik Tanya 3Quinn Thomas C. 4Santelli John 5Spencer Simon EF 6Wawer Maria J 7Grabowski M Kate 8Monod M¨|lodie 2Serwadda David 9Ssempijja Victor 10Akullian Adam 11Blenkinsop Alexandra 2Gray Ronald H 12Hall Matthew 13Dan Shozen 2Reynolds Steven J. 14Fraser Christophe 15Xi Xiaoyue 2Sewankambo Nelson K. 16Jackson Jade C 17Godfrey-Faussett Peter 18Brizzi Andrea 2Galiwango Ronald M 19Chang Larry W 20Mills Lisa A. 21Bonsall David 22D?rner Lucie Abeler 13Laeyendecker Oliver 23Kankaka Edward Nelson 24Chen Yu 2Kigozi Godfrey 19Ssekubugu Robert 19Kagaayi Joseph 19Thomson Laura13
作者信息
- 1. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health
- 2. Department of Mathematics, Imperial College London
- 3. Sydney Infectious Diseases Institute, School of Medical Sciences, Faculty of Medicine and Health, University of Sydney||Big Data Institute, Nuffield Department of Medicine, University of Oxford
- 4. Department of Pathology, Johns Hopkins School of Medicine||Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health||Department of Medicine, Johns Hopkins School of Medicine
- 5. Population and Family Health and Pediatrics, Columbia Mailman School of Public Health
- 6. Department of Statistics, University of Warwick
- 7. Rakai Health Sciences Program||Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health
- 8. Rakai Health Sciences Program||Department of Pathology, Johns Hopkins School of Medicine||Department of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine
- 9. Rakai Health Sciences Program||College of Health Sciences, School of Medicine, Makerere University
- 10. Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research||Statistics Department, Rakai Health Sciences Program
- 11. Bill and Melinda Gates Foundation
- 12. Professor Emeritus, Department of Epidemiology, Johns Hopkins University, Bloomberg School of Public Health
- 13. Big Data Institute, University of Oxford
- 14. Rakai Health Sciences Program||Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health||Department of Medicine, Johns Hopkins School of Medicine
- 15. Big Data Institute, University of Oxford||Pandemic Sciences Institute, Univeristy of Oxford
- 16. College of Health Sciences, School of Medicine, Makerere University
- 17. Department of Pathology, Johns Hopkins School of Medicine
- 18. Department of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine
- 19. Rakai Health Sciences Program
- 20. Division of Infectious diseases, Johns Hopkins School of Medicine
- 21. Division of Global HIV and TB, U. S. Centers for Disease Control and Prevention
- 22. Wellcome Centre for Human Genomics, Nuffield Department of Medicine, Univeristy of Oxford||Pandemic Sciences Institute, Univeristy of Oxford
- 23. Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health||Department of Medicine, Johns Hopkins School of Medicine
- 24. Division of Infectious diseases, Johns Hopkins School of Medicine||Research Department, Rakai Health Sciences Program
- 折叠
Abstract
Abstract
HIV incidence in eastern and southern Africa has historically been concentrated among girls and women aged 15-24 years, but as new cases decline with HIV interventions, population-level infection dynamics may shift by age and gender. Here, we integrated population-based surveillance and longitudinal deep-sequence viral phylogenetics to assess how HIV incidence and the population groups driving transmission have evolved over a 15 year period from 2003 to 2018 in Uganda. HIV viral suppression increased more rapidly in women than men, resulting in 1.5-2 fold higher suppression rates in women with HIV by 2018 across age groups. Incidence declined more slowly in women than men, increasing pre-existing gender imbalance in HIV burden. Age-specific transmission flows shifted; the share of transmission to girls and women aged 15-24 years from older men declined by approximately one third, whereas the contribution of transmission to women aged 25-34 years from men aged 0-6 years older doubled from 2003 to 2018. We estimated closing the gender gap in viral suppression could have reduced HIV incidence in women by half in 2018 and ended gender disparities in incidence. This study suggests that male-targeted HIV programs to increase HIV suppression are critical to reduce incidence in women, close gender gaps in infection burden and improve men’s health in Africa.引用本文复制引用
Ssekasanvu Joseph,Ratmann Oliver,Golubchik Tanya,Quinn Thomas C.,Santelli John,Spencer Simon EF,Wawer Maria J,Grabowski M Kate,Monod M¨|lodie,Serwadda David,Ssempijja Victor,Akullian Adam,Blenkinsop Alexandra,Gray Ronald H,Hall Matthew,Dan Shozen,Reynolds Steven J.,Fraser Christophe,Xi Xiaoyue,Sewankambo Nelson K.,Jackson Jade C,Godfrey-Faussett Peter,Brizzi Andrea,Galiwango Ronald M,Chang Larry W,Mills Lisa A.,Bonsall David,D?rner Lucie Abeler,Laeyendecker Oliver,Kankaka Edward Nelson,Chen Yu,Kigozi Godfrey,Ssekubugu Robert,Kagaayi Joseph,Thomson Laura.Growing gender disparity in HIV infection in Africa: sources and policy implications[EB/OL].(2025-03-28)[2026-04-03].https://www.medrxiv.org/content/10.1101/2023.03.16.23287351.学科分类
医学研究方法/预防医学/医药卫生理论
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