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Empirical validation of the UNAIDS Spectrum model for subnational HIV estimates: case-study of children and adults in Manicaland, Zimbabwe

BACKGROUND: More cost-effective HIV control may be achieved by targeting geographical areas with high infection rates. The AIDS Impact model of Spectrum –— used routinely to produce national HIV estimates –— could provide the required subnational estimates but is rarely validated with empirical data...

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Autores principales: Silhol, Romain, Gregson, Simon, Nyamukapa, Constance, Mhangara, Mutsa, Dzangare, Janet, Gonese, Elizabeth, Eaton, Jeffrey W., Case, Kelsey K., Mahy, Mary, Stover, John, Mugurungi, Owen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10660499/
https://www.ncbi.nlm.nih.gov/pubmed/28296799
http://dx.doi.org/10.1097/QAD.0000000000001418
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author Silhol, Romain
Gregson, Simon
Nyamukapa, Constance
Mhangara, Mutsa
Dzangare, Janet
Gonese, Elizabeth
Eaton, Jeffrey W.
Case, Kelsey K.
Mahy, Mary
Stover, John
Mugurungi, Owen
author_facet Silhol, Romain
Gregson, Simon
Nyamukapa, Constance
Mhangara, Mutsa
Dzangare, Janet
Gonese, Elizabeth
Eaton, Jeffrey W.
Case, Kelsey K.
Mahy, Mary
Stover, John
Mugurungi, Owen
author_sort Silhol, Romain
collection PubMed
description BACKGROUND: More cost-effective HIV control may be achieved by targeting geographical areas with high infection rates. The AIDS Impact model of Spectrum –— used routinely to produce national HIV estimates –— could provide the required subnational estimates but is rarely validated with empirical data, even at a national level. DESIGN: The validity of the Spectrum model estimates were compared with empirical estimates. METHODS: Antenatal surveillance and population survey data from a population HIV cohort study in Manicaland, East Zimbabwe, were input into Spectrum 5.441 to create a simulation representative of the cohort population. Model and empirical estimates were compared for key demographic and epidemiological outcomes. Alternative scenarios for data availability were examined and sensitivity analyses were conducted for model assumptions considered important for subnational estimates. RESULTS: Spectrum estimates generally agreed with observed data but HIV incidence estimates were higher than empirical estimates, whereas estimates of early age all-cause adult mortality were lower. Child HIV prevalence estimates matched well with the survey prevalence among children. Estimated paternal orphanhood was lower than empirical estimates. Including observations from earlier in the epidemic did not improve the HIV incidence model fit. Migration had little effect on observed discrepancies –— possibly because the model ignores differences in HIV prevalence between migrants and residents. CONCLUSION: The Spectrum model, using subnational surveillance and population data, provided reasonable subnational estimates although some discrepancies were noted. Differences in HIV prevalence between migrants and residents may need to be captured in the model if applied to subnational epidemics.
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spelling pubmed-106604992023-11-21 Empirical validation of the UNAIDS Spectrum model for subnational HIV estimates: case-study of children and adults in Manicaland, Zimbabwe Silhol, Romain Gregson, Simon Nyamukapa, Constance Mhangara, Mutsa Dzangare, Janet Gonese, Elizabeth Eaton, Jeffrey W. Case, Kelsey K. Mahy, Mary Stover, John Mugurungi, Owen AIDS Article BACKGROUND: More cost-effective HIV control may be achieved by targeting geographical areas with high infection rates. The AIDS Impact model of Spectrum –— used routinely to produce national HIV estimates –— could provide the required subnational estimates but is rarely validated with empirical data, even at a national level. DESIGN: The validity of the Spectrum model estimates were compared with empirical estimates. METHODS: Antenatal surveillance and population survey data from a population HIV cohort study in Manicaland, East Zimbabwe, were input into Spectrum 5.441 to create a simulation representative of the cohort population. Model and empirical estimates were compared for key demographic and epidemiological outcomes. Alternative scenarios for data availability were examined and sensitivity analyses were conducted for model assumptions considered important for subnational estimates. RESULTS: Spectrum estimates generally agreed with observed data but HIV incidence estimates were higher than empirical estimates, whereas estimates of early age all-cause adult mortality were lower. Child HIV prevalence estimates matched well with the survey prevalence among children. Estimated paternal orphanhood was lower than empirical estimates. Including observations from earlier in the epidemic did not improve the HIV incidence model fit. Migration had little effect on observed discrepancies –— possibly because the model ignores differences in HIV prevalence between migrants and residents. CONCLUSION: The Spectrum model, using subnational surveillance and population data, provided reasonable subnational estimates although some discrepancies were noted. Differences in HIV prevalence between migrants and residents may need to be captured in the model if applied to subnational epidemics. 2017-04 /pmc/articles/PMC10660499/ /pubmed/28296799 http://dx.doi.org/10.1097/QAD.0000000000001418 Text en https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Article
Silhol, Romain
Gregson, Simon
Nyamukapa, Constance
Mhangara, Mutsa
Dzangare, Janet
Gonese, Elizabeth
Eaton, Jeffrey W.
Case, Kelsey K.
Mahy, Mary
Stover, John
Mugurungi, Owen
Empirical validation of the UNAIDS Spectrum model for subnational HIV estimates: case-study of children and adults in Manicaland, Zimbabwe
title Empirical validation of the UNAIDS Spectrum model for subnational HIV estimates: case-study of children and adults in Manicaland, Zimbabwe
title_full Empirical validation of the UNAIDS Spectrum model for subnational HIV estimates: case-study of children and adults in Manicaland, Zimbabwe
title_fullStr Empirical validation of the UNAIDS Spectrum model for subnational HIV estimates: case-study of children and adults in Manicaland, Zimbabwe
title_full_unstemmed Empirical validation of the UNAIDS Spectrum model for subnational HIV estimates: case-study of children and adults in Manicaland, Zimbabwe
title_short Empirical validation of the UNAIDS Spectrum model for subnational HIV estimates: case-study of children and adults in Manicaland, Zimbabwe
title_sort empirical validation of the unaids spectrum model for subnational hiv estimates: case-study of children and adults in manicaland, zimbabwe
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10660499/
https://www.ncbi.nlm.nih.gov/pubmed/28296799
http://dx.doi.org/10.1097/QAD.0000000000001418
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