Short communication: Prioritizing communities for HIV prevention in sub-Saharan Africa.
HIV prevalence is the most commonly used measure to prioritize communities for HIV prevention. We show that data on two HIV infection stages (early vs. nonearly and late vs. nonlate) allow estimation of two better measures of prevention need: HIV incidence (for prevention of HIV acquisition) and expected probability of HIV transmission in unprotected sex acts between HIV-infected community members and susceptible individuals (for prevention of HIV transmission). The three ranking schemes--by prevalence, incidence, and transmission probability--lead to significantly different community rank orders. Disease stage information should be collected in HIV surveys.
Bärnighausen
Till
T
Department of Global Health and Population, Harvard School of Public Health, Boston, Massachusetts, USA. tbarnighausen@africacentre.ac.za
Tanser
Frank
F
Hallett
Timothy
T
Newell
Marie-Louise
ML
D000293:Adolescent; D000328:Adult; D017954:Africa South of the Sahara / Q000453:epidemiology; D018672:Community Health Planning / Q000379:methods*; D003153:Community Health Services; D005260:Female; D006678:HIV; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D006292:Health Priorities; D006301:Health Services Needs and Demand; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D047568:Unsafe Sex