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Has Global HIV Incidence Peaked?

J. Shelton, Daniel T Halperin, D. Wilson
Published 2006 · Medicine

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Rajesh Kumar and colleagues in todays Lancet document a declining prevalence of HIV-1 in young adults in South India. This evidence along with other recent positive findings provides impetus to re-examine the HIV pandemic. Many readers may be surprised that available evidence indicates that HIV incidence (rate of new infections) has peaked overall in Africa--indeed it did so some years ago. And even the lagging indicator of HIV prevalence (rate of existing infections) has also declined in an increasingly impressive number of African settings and elsewhere. One reason that this decline in incidence is poorly appreciated is because attention often focuses on prevalence. To understand the interplay of HIV incidence and prevalence Kenya is illustrative. According to modelling by the US Census Bureau new infections peaked around 1992-93. However because of the many years of latency between HIV infection and mortality prevalence continued to rise even as incidence fell--and peaked around 1997 when mortality finally rose to match incidence. (excerpt)
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