Using estimation and projection package and Spectrum for Jamaica's national HIV estimates and targets

Abstract

Background: Adequate coverage of target populations ensures that desired outcomes, such as increased survival of people living with HIV, are achieved. However, estimates of coverage and impact of HIV programmes using available data are limited by the complex natural history of HIV, underreporting of cases and inadequate information systems.

Methods: Jamaica's national HIV estimates were generated using the 2009 version of the UNAIDS estimation and projection package (EPP) and Spectrum. National data used included sentinel surveillance data on antenatal clinic attendees (1986-2005 and 2007), distribution of antiretroviral regimes for prevention of mother-to-child transmission, distribution of antiretroviral therapy (ART) among adults and ART distribution in subpopulations (e.g., men who have sex with men (MSM) and sex workers). Surveys of MSM (2007), sex worker (2001, 2005, 2008), STI clinic attendees (1990-2002) and inmates (2006) also provided inputs.

Results: In 2009, Jamaica's HIV prevalence was estimated at 1.7% (range 1.1-2.5) and 31 000 (range 20 000-43 000) adults (>15 years) were living with HIV. The number of adults in need of treatment was 15 000 (range 11 000-19 000) and approximately 2100 new infections occurred in 2009. The EPP/Spectrum estimates were generally consistent with locally available data. However, the number of persons with advanced HIV targeted by the national treatment programme was significantly lower than Spectrum's estimated target population.

Conclusion: EPP/Spectrum can provide important data for national HIV programme planning. Improved monitoring and evaluation systems will provide quality data and result in more robust estimates.

Figure 1

Spectrum projection of adult HIV prevalence in Jamaica.