title: Embracing different approaches to estimating HIV incidence, prevalence and mortality.
abstract: BACKGROUND
  Joint United Nations Programme on HIV/AIDS (UNAIDS) and Murray et al. have both produced sets of estimates for worldwide HIV incidence, prevalence and mortality. Understanding differences in these estimates can strengthen the interpretation of each.
  
  
  METHODS
  We describe differences in the two sets of estimates. Where possible, we have drawn on additional published data to which estimates can be compared.
  
  
  RESULTS
  UNAIDS estimates that there were 6 million more people living with HIV (PLHIV) in 2013 (35 million) compared with the Murray et al. estimates (29 million). Murray et al. estimate that new infections and AIDS deaths have declined more gradually than does UNAIDS. Just under one third of the difference in PLHIV is in Africa, where Murray et al. have relied more on estimates of adult mortality trends than on data on survival times. Another third of the difference is in North America, Europe, Central Asia and Australasia. Here Murray et al. estimates of new infections are substantially lower than the number of new HIV/AIDS diagnoses reported by countries, whereas published UNAIDS estimate tend to be greater. The remaining differences are in Latin America and Asia where the data upon which the UNAIDS methods currently rely are more sparse, whereas the mortality data leveraged by Murray et al. may be stronger. In this region, however, anomalies appear to exist between the both sets of estimates and other data.
  
  
  CONCLUSIONS
  Both estimates indicate that approximately 30 million PLHIV and that antiretroviral therapy has driven large reductions in mortality. Both estimates are useful but show instructive discrepancies with additional data sources. We find little evidence to suggest that either set of estimates can be considered systematically more accurate. Further work should seek to build estimates on as wide a base of data as possible.
authors.affiliation: aImperial College London bLondon School of Hygiene and Tropical Medicine, London UK cFutures Institute, Glastonbury, Massachusetts dEast-West Centre, Hawaii, USA eKirby Institute, University of New South Wales, Sydney, Australia.
authors.forename: Timothy B
authors.initials: TB
authors.lastname: Hallett
authors.forename: Basia
authors.initials: B
authors.lastname: Zaba
authors.forename: John
authors.initials: J
authors.lastname: Stover
authors.forename: Tim
authors.initials: T
authors.lastname: Brown
authors.forename: Emma
authors.initials: E
authors.lastname: Slaymaker
authors.forename: Simon
authors.initials: S
authors.lastname: Gregson
authors.forename: David P
authors.initials: DP
authors.lastname: Wilson
authors.forename: Kelsey K
authors.initials: KK
authors.lastname: Case
mesh_terms: D004812:Epidemiologic Methods; D014943:Global Health; D015658:HIV Infections / Q000453:epidemiology* / Q000401:mortality*; D006801:Humans; D015994:Incidence; D015995:Prevalence; D016019:Survival Analysis