Global and regional disease burden of HIV/AIDS from 1990 to 2021 and projections to 2030
Yan Lu, Huiqin Li, Rong‐Jing Dong, Mi Zhang, Xingqi Dong, Cuixian Yang, Xicheng Wang, J Ye
Abstract
BACKGROUND: Few studies have focused on the descriptive epidemiology and trends of HIV/AIDS since the publication of the Global Burden of Disease (GBD) study in 2021. Therefore, this study aims to analyze the trends and patterns of the HIV/AIDS burden at the global, regional, and national levels by sex, age and social development index (SDI). We also explored risk factors and predicted the GBD of HIV/AIDS until 2030. METHODS: Data on the etiology of HIV/AIDS from 1990 to 2021 were collected from the 2021 GBD database. Estimated annual percent changes (EAPCs) were calculated to assess temporal trends in the age-standardized incidence rate (ASIR), age-standardized disability-adjusted life-year rate (ASDR) and age-standardized mortality rate (ASMR) of HIV/AIDS patients. Measures categorized by sex, region, age and SDI quintiles. In addition, an age‒period‒cohort model was established to forecast future trends of the HIV/AIDS burden to 2030. RESULTS: Globally, the incidence of HIV/AIDS reached 1.65 million (95% uncertainty interval 1.48 to 1.82) in 2021. From 1990 to 2021, the global ASIR of HIV/AIDS showed a downward trend, with an EAPC of 0.14% (0.12-0.16%). The ASIR, ASDR, and ASMR of HIV/AIDS were highest in the low-SDI region and lowest in the high-SDI region. Regionally, southern sub-Saharan Africa had the highest ASIR in 2021, whereas Oceania had the largest increase in the ASIR from 1990 to 2021. Burundi (EAPC 14.04%, 95% CI -13.63 to -14.44%), followed by Burkina Faso, exhibited the most significant decrease in the ASIR. Globally, the highest incidence rate was observed in the 25-29 years old group. Unsafe sex is the primary factor leading to the burden of HIV/AIDS. By 2030, the global ASIR, ASDR and ASMR of HIV/AIDS are expected to gradually decrease. CONCLUSION: HIV/AIDS disease burden varies by region, sex, and age. The global burden of HIV/AIDS is substantial in low-income regions, especially in Sub-Saharan Africa. Our study offers valuable epidemiological evidence for future research on the prevention and treatment of HIV/AIDS.