Spatial and temporal trends in HIV/AIDS burden among South Asian countries from 1990 to 2021: A systematic examination of the Global Burden of Disease study 2021

IF 2.8 3区医学 Q2 INFECTIOUS DISEASES

HIV Medicine Pub Date : 2025-02-19 DOI:10.1111/hiv.70003

Akashanand, Mahalaqua Nazli Khatib, Hashem Abu Serhan, Diptismita Jena, G. PadmaPriya, Pawan Sharma, Pradeep Soothwal, Amit Barwal, M. Ravi Kumar, Pranchal Rajput, Lara Jain, Abhay M. Gaidhane, Ganesh Bushi, Muhammed Shabil, Rachana Mehta, Kiran Bhopte, Manika Gupta, Sanjit Sah

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Abstract

Background

HIV/AIDS remains a significant public health concern in South Asia, and trends in disease burden vary across the region. This study analyzed spatial and temporal trends in HIV/AIDS from 1990 to 2021 using data from the Global Burden of Disease (GBD) study 2021, focusing on incidence, prevalence, mortality, and disability-adjusted life-years (DALYs).

Methods

We conducted a secondary analysis of GBD 2021 data, applying Joinpoint regression and auto-regressive integrated moving average models to assess trends in HIV/AIDS burden across South Asian countries. We calculated metrics such as average annual percentage change (AAPC), and estimated APC (EAPC) to evaluate temporal trends.

Results

We found significant variations in HIV/AIDS trends across South Asia. India had the highest burden, with a sharp increase in DALYs between 1990 and 2000 with a percentage change (PC) of 184.09, followed by a decline (−0.73 in 2010–2021). Pakistan experienced the highest growth in DALYs and mortality (average PC 36.46; estimated PC 38.65), indicating severe ongoing public health challenges. In contrast, Nepal and Maldives showed notable reductions in both DALYs and mortality rates, reflecting successful intervention efforts. Afghanistan and Bangladesh exhibited fluctuating trends, with slight increases in the initial years followed by stabilization or modest declines. Auto-regressive integrated moving average projections suggested a slight increase in HIV/AIDS incidence by 2031, with mortality rates expected to decline more significantly.

Conclusion

The burden of HIV/AIDS in South Asia varies significantly, with some countries achieving reductions and others, particularly Pakistan, facing rising challenges. Continued and targeted public health interventions are crucial for managing and reducing the burden of HIV/AIDS across South Asia.

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1990年至2021年南亚国家艾滋病毒/艾滋病负担的时空趋势：对2021年全球疾病负担研究的系统审查

背景：艾滋病毒/艾滋病仍然是南亚的一个重大公共卫生问题，该地区疾病负担的趋势各不相同。本研究使用2021年全球疾病负担（GBD）研究的数据分析了1990年至2021年艾滋病毒/艾滋病的时空趋势，重点关注发病率、流行率、死亡率和残疾调整生命年（DALYs）。方法：我们对GBD 2021数据进行了二次分析，应用Joinpoint回归和自回归综合移动平均模型来评估南亚国家艾滋病毒/艾滋病负担的趋势。我们计算了年平均百分比变化（AAPC）和估计APC （EAPC）等指标来评估时间趋势。结果：我们发现南亚地区的艾滋病毒/艾滋病趋势存在显著差异。印度的负担最重，1990年至2000年期间DALYs急剧增加，百分比变化（PC）为184.09，随后下降（2010-2021年为-0.73）。巴基斯坦的残疾调整生命年和死亡率增长最高(平均为36.46；估计pc38.65)，表明公共卫生面临严峻挑战。相比之下，尼泊尔和马尔代夫的伤残调整生命年和死亡率均有显著下降，这反映出干预工作取得了成功。阿富汗和孟加拉国呈现波动趋势，最初几年略有增加，随后趋于稳定或略有下降。自回归综合移动平均预测表明，到2031年，艾滋病毒/艾滋病发病率略有上升，死亡率预计将更大幅度下降。结论：南亚地区的艾滋病毒/艾滋病负担差异很大，一些国家实现了减少，而其他国家，特别是巴基斯坦，面临着越来越大的挑战。持续和有针对性的公共卫生干预措施对于管理和减轻整个南亚的艾滋病毒/艾滋病负担至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

HIV Medicine 医学-传染病学

CiteScore

5.10

自引率

10.00%

发文量

167

审稿时长

6-12 weeks

期刊介绍： HIV Medicine aims to provide an alternative outlet for publication of international research papers in the field of HIV Medicine, embracing clinical, pharmocological, epidemiological, ethical, preclinical and in vitro studies. In addition, the journal will commission reviews and other feature articles. It will focus on evidence-based medicine as the mainstay of successful management of HIV and AIDS. The journal is specifically aimed at researchers and clinicians with responsibility for treating HIV seropositive patients.