Age patterns and sex ratios of adult mortality in countries with high HIV prevalence

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Title: Age patterns and sex ratios of adult mortality in countries with high HIV prevalence
Authors: Masquelier, B
Eaton, JW
Gerland, P
Pelletier, F
Mutai, KK
Item Type: Journal Article
Abstract: Objective: To compare the 2016 United Nations Programme on HIV/AIDS (UNAIDS) modelled estimates of adult mortality in sub-Saharan Africa to empirical estimates. Design: Age-specific mortality rates were obtained from nationally representative sibling survival data, recent household deaths and vital registration, and directly compared with UNAIDS estimates. Orphanhood prevalence derived from UNAIDS mortality estimates was compared with survey and census reports on the survival of children's parents. Methods: Age-specific mortality rates for adults aged 15–59 years were calculated from Demographic and Health Surveys and deaths reported in censuses or vital registration, adjusted for underreporting, whenever possible. Proportions of orphans were extracted from censuses and surveys for children aged 5–9 years. Results: UNAIDS estimates were significantly higher than sibling mortality estimates, except among men in countries with very high HIV prevalence. There was a better agreement between rates based on household deaths or vital registration and model outputs. Sex ratios (M/F) of adult mortality were lower in UNAIDS estimates. The modelled orphan prevalence was significantly higher than in surveys and censuses, again with the exception of paternal orphans in countries with very high HIV prevalence. Ratios of paternal-to-maternal orphans were lower in the UNAIDS model than surveys and censuses. Among women, increases in mortality due to AIDS were more concentrated in the age range 25–50 years in model outputs, as compared with empirical estimates. Conclusion: Discrepancies in levels, sex ratios and age patterns of adult mortality between empirical and UNAIDS estimates call for additional data quality assessments and improvements in estimation methods.
Issue Date: 1-Apr-2017
Date of Acceptance: 1-Nov-2016
ISSN: 0269-9370
Start Page: S77
End Page: S85
Journal / Book Title: AIDS
Volume: 31
Issue: Supplement 1
Copyright Statement: © 2017 The Author(s). Published by Wolters Kluwer Health, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND, where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
Keywords: Science & Technology
Life Sciences & Biomedicine
Infectious Diseases
demographic and health surveys
life tables
sub-Saharan Africa
06 Biological Sciences
11 Medical And Health Sciences
17 Psychology And Cognitive Sciences
Publication Status: Published
Open Access location:
Appears in Collections:Epidemiology, Public Health and Primary Care

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