Current HIV/AIDS Reports

, Volume 11, Issue 2, pp 93–98 | Cite as

Global HIV Epidemiology: A Guide for Strategies in Prevention and Care

  • Sten H. Vermund
Invited Commentary


Global trends in HIV incidence are estimated typically by serial prevalence surveys in selected sentinel populations or less often in representative population samples. Incidence estimates are often modeled because cohorts are costly to maintain and are rarely representative of larger populations. From global trends, we can see reason for cautious optimism. Downward trends in generalized epidemics in Africa, concentrated epidemics in persons who inject drugs (PWID), some female sex worker cohorts, and among older men who have sex with men (MSM) have been noted. However, younger MSM and those from minority populations, as with black MSM in the United States, show continued transmission at high rates. Among the many HIV prevention strategies, current efforts to expand testing, linkage to effective care, and adherence to antiretroviral therapy are known as “treatment as prevention” (TasP). A concept first forged for the prevention of mother to child transmission, TasP generates high hopes that persons treated early will derive considerable clinical benefits and that lower infectiousness will reduce transmission in communities. With the global successes of risk reduction for PWID, we have learned that reducing marginalization of the at-risk population, implementation of nonjudgmental and pragmatic sterile needle and syringe exchange programs, and offering of opiate substitution therapy to help persons eschew needle use altogether can work to reduce the HIV epidemic. Never has the urgency of stigma reduction and guarantees of human rights been more urgent; a public health approach to at-risk populations requires that to avail themselves of prevention services and they must feel welcomed.


HIV Global epidemic Surveillance Global Prevention Epidemiology Barriers Human rights HIV prevention strategies Men who have sex with men (MSM) Persons who inject drugs (PWID) 



Supported in part by NIH grant #UM1 AI068619, the HIV Prevention Trials Network (HPTN) Leadership Group.

Compliance with Ethics Guidelines

Conflict of Interest

Sten H. Vermund reports that he serves as a consultant for the World Bank, the WHO, and UNAIDS.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.••
    Delva W, Abdool Karim Q. The HIV epidemic in Southern Africa—Is an AIDS-free generation possible? Curr HIV AIDS Rep. 2014; doi: 10.1007/s11904-014-0205-0. The authors present an epidemiologic update and prospects for progress in the world’s HIV epicenter of southern Africa.
  2. 2.
    Leclerc PM, Matthews AP, Garenne ML. Fitting the HIV epidemic in Zambia: a two-sex micro-simulation model. PLoS One. 2009;4:e5439.PubMedCentralPubMedCrossRefGoogle Scholar
  3. 3.
    Okal J, Geibel S, Muraguri N, et al. Estimates of the size of key populations at risk for HIV infection: men who have sex with men, female sex workers and injecting drug users in Nairobi,Kenya. Sex Transm Infect. 2013;89:366–71.PubMedCrossRefGoogle Scholar
  4. 4.
    Beyrer C, Abdool KQ. The changing epidemiology of HIV in 2013. Curr Opin HIV AIDS. 2013;8:306–10.PubMedGoogle Scholar
  5. 5.
    Epstein H, Morris M. Concurrent partnerships and HIV: an inconvenient truth. J Int AIDS Soc. 2011;14:13.PubMedCentralPubMedCrossRefGoogle Scholar
  6. 6.
    Sawers L. Measuring and modelling concurrency. J Int AIDS Soc. 2013;16:17431.PubMedCentralPubMedCrossRefGoogle Scholar
  7. 7.••
    Suguimoto SP, Techasrivichien T, Musumari PM, et al. Changing patterns of HIV epidemic in 30 years in East Asia. Curr HIV AIDS Rep. 2014; doi: 10.1007/s11904-014-0201-4. The authors present both recent trends and challenges of HIV amidst the vast population of East Asia.
  8. 8.•
    Ye S, Pang L, Wang X. Epidemiological implications of HIV-hepatitis C co-infection in South and Southeast Asia. Curr HIV AIDS Rep. 2014; doi: 10.1007/s11904-014-0206-z. A brief review of HIV-HCV co-infection focused on south and southeast Asia indicates the challenge facing Asia.
  9. 9.
    Samo RN, Altaf A, Agha A, et al. High HIV incidence among persons who inject drugs in Pakistan: greater risk with needle sharing and injecting frequently among the homeless. PLoS One. 2013;8:e81715.PubMedCentralPubMedCrossRefGoogle Scholar
  10. 10.
    Steen R, Zhao P, Wi TE, Punchihewa N, Abeyewickreme I, Lo YR. Halting and reversing HIV epidemics in Asia by interrupting transmission in sex work: experience and outcomes from ten countries. Expert Rev Anti Infect Ther. 2013;11:999–1015.PubMedCrossRefGoogle Scholar
  11. 11.
    van Griensven F, Thienkrua W, McNicholl J, et al. Evidence of an explosive epidemic of HIV infection in a cohort of men who have sex with men in Thailand. AIDS. 2013;27:825–32.PubMedCrossRefGoogle Scholar
  12. 12.••
    Garcia PJ, Bayer A, Cárcamo CP. The changing face of HIV in Latin America and the Caribbean. Curr HIV AIDS Rep. 2014; [In press]. doi: 10.1007/s11904-014-0204-1. The authors present a comprehensive assessment of the multifaceted epidemic in the Americas south of the USA/Canada.
  13. 13.••
    Figueroa JP. Review of HIV in the Caribbean: significant progress and outstanding challenges. Curr HIV AIDS Rep. 2014; doi: 10.1007/s11904-014-0199-7. The author describes the complex epidemiology of different island HIV transmission patterns.
  14. 14.••
    Nakagawa F, Phillips AN, Lundgren JD. HIV in Western Europe. Curr HIV AIDS Rep. 2014; [In press]. doi: 10.1007/s11904-014-0198-8. The authors present a current and historic perspective on Western Europe’s struggle with HIV/AIDS.
  15. 15.
    Vermund SH, Leigh-Brown AJ. The HIV epidemic: high-income countries. Cold Spring Harb Perspect Med. 2012;2:a007195.PubMedCentralPubMedCrossRefGoogle Scholar
  16. 16.
    Plummer D, Irwin L. Grassroots activities, national initiatives and HIV prevention: clues to explain Australia's dramatic early success in controlling the HIV epidemic. Int J STD AIDS. 2006;17:787–93.PubMedCrossRefGoogle Scholar
  17. 17.••
    DeHovitz J, Uusküla A, El-Bassel N. The HIV epidemic in Eastern Europe and Central Asia. Curr HIV AIDS Rep. 2014; doi: 10.1007/s11904-014-0202-3. The authors review epidemiologic trends and prevention challenges for the epidemic in Eastern Europe and Central Asia, largely driven by injection drug use.
  18. 18.
    Vagenas P, Azbel L, Polonsky M, et al. A review of medical and substance use co-morbidities in Central Asian prisons: implications for HIV prevention and treatment. Drug Alcohol Depend. 2013;132 Suppl 1:S25–31.PubMedCrossRefGoogle Scholar
  19. 19.•
    Dunlap J, Foderingham N, Bussell S, Wester CW, Audet CM, Aliyu MH. Male involvement for the prevention of mother-to-child HIV transmission: a brief review of initiatives in East, West and Central Africa. Curr HIV AIDS Rep. 2014; doi: 10.1007/s11904-014-0200-5. Concentrating on sub-Saharan Africa exclusive of the 10 nations in southern Africa, the authors highlight an innovative approach to improving PMTCT coverage, namely the engagement of men in antenatal, intrapartum, and postpartum care.
  20. 20.•
    Roxby AC, Unger JA, Slyker JA et al. A lifecycle approach to HIV prevention in African women and children. Curr HIV AIDS Rep. 2014; doi: 10.1007/s11904-014-0203-2. The authors put HIV care in the broader context of overall health and prevention needs, describing a lifecycle approach for sustained epidemic response.
  21. 21.
    Crosby RA. State of condom use in HIV prevention science and practice. Curr HIV AIDS Rep. 2013;10:59–64.CrossRefGoogle Scholar
  22. 22.
    Baeten JM, Haberer JE, Liu AY, Sista N. Pre-exposure prophylaxis for HIV prevention: where have we been and where are we going? J Acquir Immune Defic Syndr. 2013;63 Suppl 2:S122–9.PubMedCrossRefGoogle Scholar
  23. 23.
    Amico KR, Mansoor LE, Corneli A, Torjesen K, van der Straten A. Adherence support approaches in biomedical HIV prevention trials: experiences, insights and future directions from four multisite prevention trials. AIDS Behav. 2013;17:2143–55.PubMedCentralPubMedCrossRefGoogle Scholar
  24. 24.
    Persaud D, Gay H, Ziemniak C, et al. Absence of detectable HIV-1 viremia after treatment cessation in an infant. N Engl J Med. 2013;369:1828–35.PubMedCentralPubMedCrossRefGoogle Scholar
  25. 25.
    Nielsen-Saines K, Watts DH, Veloso VG, et al. Three postpartum antiretroviral regimens to prevent intrapartum HIV infection. N Engl J Med. 2012;366:2368–79.PubMedCentralPubMedCrossRefGoogle Scholar
  26. 26.
    Tieu HV, Rolland M, Hammer SM, Sobieszczyk ME. Translational research insights from completed HIV vaccine efficacy trials. J Acquir Immune Defic Syndr. 2013;63 Suppl 2:S150–4.PubMedCrossRefGoogle Scholar
  27. 27.
    Fideli US, Allen SA, Musonda R, et al. Virologic and immunologic determinants of heterosexual transmission of HIV-type 1 (HIV-1) in Africa. AIDS Res Hum Retrovir. 2001;17:901–10.PubMedCentralPubMedCrossRefGoogle Scholar
  28. 28.
    Quinn TC, Wawer MJ, Sewankambo N, et al. Viral load and heterosexual transmission of human immunodeficiency virus type 1. Rakai Project Study Group. N Engl J Med. 2000;342:921–9.PubMedCrossRefGoogle Scholar
  29. 29.
    Cohen MS, Chen YQ, McCauley M, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011;365:493–505.PubMedCentralPubMedCrossRefGoogle Scholar
  30. 30.
    Shelton JD. HIV/AIDS. ARVs as HIV prevention: a tough road to wide impact. Science. 2011;334:1645–6.PubMedCrossRefGoogle Scholar
  31. 31.
    Wilson DP. HIV treatment as prevention: natural experiments highlight limits of antiretroviral treatment as HIV prevention. PLoS Med. 2012;9:e1001231.PubMedCentralPubMedCrossRefGoogle Scholar
  32. 32.
    Modelling HIV. Consortium Treatment as Prevention Editorial Writing Group. HIV treatment as prevention: models, data, and questions–towards evidence-based decision-making. PLoS Med. 2012;9:e1001259.CrossRefGoogle Scholar
  33. 33.
    Granich R, Gupta S, Suthar AB, et al. Antiretroviral therapy in prevention of HIV and TB: update on current research efforts. Curr HIV Res. 2011;9:446–69.PubMedCentralPubMedCrossRefGoogle Scholar
  34. 34.
    Iwuji CC, Orne-Gliemann J, Tanser F, et al. Evaluation of the impact of immediate versus WHO recommendations-guided antiretroviral therapy initiation on HIV incidence: the ANRS 12249 TasP (Treatment as Prevention) trial in Hlabisa sub-district, KwaZulu-Natal, South Africa: study protocol for a cluster randomised controlled trial. Trials. 2013;14:230.PubMedCentralPubMedCrossRefGoogle Scholar
  35. 35.
    Tanser F, Bärnighausen T, Grapsa E, Zaidi J, Newell ML. High coverage of ART associated with decline in risk of HIV acquisition in rural KwaZulu-Natal, South Africa. Science. 2013;339:966–71.PubMedCrossRefGoogle Scholar
  36. 36.
    Jain V, Byonanebye DM, Liegler T, et al. Changes in population HIV RNA levels in Mbarara, Uganda, during scale-up of HIV antiretroviral therapy access. J Acquir Immune Defic Syndr. 2014;65:327–32.PubMedCrossRefGoogle Scholar
  37. 37.
    Chamie G, Kwarisiima D, Clark TD, et al. Uptake of community-based HIV testing during a multi-disease health campaign in rural Uganda. PLoS One. 2014;9:e84317.PubMedCentralPubMedCrossRefGoogle Scholar
  38. 38.
    Vermund SH, Fidler SJ, Ayles H, Beyers N, Hayes RJ. Can combination prevention strategies reduce HIV transmission in generalized epidemic settings in Africa? The HPTN 071 (PopART) study plan in South Africa and Zambia. J Acquir Immune Defic Syndr. 2013;63(2):S221–7.PubMedCrossRefGoogle Scholar
  39. 39.
    Cori A, Ayles H, Beyers N, et al. HPTN 071 (PopART): a cluster-randomized trial of the population impact of an HIV combination prevention intervention including universal testing and treatment: mathematical model. PLoS One. 2014;9:e84511.PubMedCentralPubMedCrossRefGoogle Scholar
  40. 40.
    Hayes R, Ayles H, Beyers N, Sabapathy K, Floyd S, Shanaube K, et al. HPTN 071 (PopART): rationale and design of a cluster-randomised trial of the population impact of an HIV combination prevention intervention including universal testing and treatment - a study protocol for a cluster randomised trial. Trials. 2014;15:57.PubMedCentralPubMedCrossRefGoogle Scholar
  41. 41.
    Gray RH, Kigozi G, Serwadda D, et al. Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial. Lancet. 2007;369:657–66.PubMedCrossRefGoogle Scholar
  42. 42.
    Bailey RC, Moses S, Parker CB, et al. Male circumcision for HIV prevention in young men in Kisumu, Kenya: a randomised controlled trial. Lancet. 2007;369:643–56.PubMedCrossRefGoogle Scholar
  43. 43.
    Auvert B, Taljaard D, Lagarde E, Sobngwi-Tambekou J, Sitta R, Puren A. Randomized, controlled intervention trial of male circumcision for reduction of HIV infection risk: the ANRS 1265 Trial. PLoS Med. 2005;2:e298.PubMedCentralPubMedCrossRefGoogle Scholar
  44. 44.
    Qian HZ, Ruan Y, Liu Y, et al. Lower odds of HIV among circumcised MSM in China and interaction with anal sexual role. Conference on Retroviruses and Opportunistic Infections (CROI); Boston, MA. 2014; p. 83. [Abstract 963].Google Scholar
  45. 45.
    Gray RH, Wawer MJ, Kigozi G. Programme science research on medical male circumcision scale-up in sub-Saharan Africa. Sex Transm Infect. 2013;89:345–9.PubMedCrossRefGoogle Scholar
  46. 46.
    Mehta SD, Moses S, Agot K, et al. The long term efficacy of medical male circumcision against HIV acquisition. AIDS. 2013;27:2899–909.CrossRefGoogle Scholar
  47. 47.
    Stringer JS, Stinson K, Tih PM, et al. Measuring coverage in MNCH: population HIV-free survival among children under two years of age in four African countries. PLoS Med. 2013;10:e1001424.PubMedCentralPubMedCrossRefGoogle Scholar
  48. 48.
    Stringer EM, Ekouevi DK, Coetzee D, et al. Coverage of nevirapine-based services to prevent mother-to-child HIV transmission in 4 African countries. JAMA. 2010;304:293–302.PubMedCrossRefGoogle Scholar
  49. 49.
    Ciampa PJ, Tique JA, Jumá N, et al. Addressing poor retention of infants exposed to HIV: a quality improvement study in rural Mozambique. J Acquir Immune Defic Syndr. 2012;60:e46–52.PubMedCentralPubMedCrossRefGoogle Scholar
  50. 50.
    Geelhoed D, Lafort Y, Chissale É, Candrinho B, Degomme O. Integrated maternal and child health services in Mozambique: structural health system limitations overshadow its effect on follow-up of HIV-exposed infants. BMC Health Serv Res. 2013;13:207.PubMedCentralPubMedCrossRefGoogle Scholar
  51. 51.
    Smith LR, Fisher JD, Cunningham CO, Amico KR. Understanding the behavioral determinants of retention in HIV care: a qualitative evaluation of a situated information, motivation, behavioral skills model of care initiation and maintenance. AIDS Patient Care STDS. 2012;26:344–55.PubMedCentralPubMedCrossRefGoogle Scholar
  52. 52.
    Laisaar KT, Uusküla A, Sharma A, DeHovitz JA, Amico KR. Developing an adherence support intervention for patients on antiretroviral therapy in the context of the recent IDU-driven HIV/AIDS epidemic in Estonia. AIDS Care. 2013;25:863–73.PubMedCrossRefGoogle Scholar
  53. 53.
    Beyrer C, Baral SD, van Griensven F, et al. Global epidemiology of HIV infection in men who have sex with men. Lancet. 2012;380:367–77.PubMedCentralPubMedCrossRefGoogle Scholar
  54. 54.
    Park LS, Siraprapasiri T, Peerapatanapokin W, Manne J, Niccolai L, Kunanusont C. HIV transmission rates in Thailand: evidence of HIV prevention and transmission decline. J Acquir Immune Defic Syndr. 2010;54:430–6.PubMedCrossRefGoogle Scholar
  55. 55.
    Hallett TB, Aberle-Grasse J, Bello G, et al. Declines in HIV prevalence can be associated with changing sexual behaviour in Uganda, urban Kenya, Zimbabwe, and urban Haiti. Sex Transm Infect. 2006;82 Suppl 1:i1–8.PubMedCentralPubMedCrossRefGoogle Scholar
  56. 56.
    Petersen Z, Myers B, van Hout MC, Plüddemann A, Parry C. Availability of HIV prevention and treatment services for people who inject drugs: findings from 21 countries. Harm Reduct J. 2013;10:13.PubMedCentralPubMedCrossRefGoogle Scholar
  57. 57.
    Mathers BM, Degenhardt L, Ali H, et al. HIV prevention, treatment, and care services for people who inject drugs: a systematic review of global, regional, and national coverage. Lancet. 2010;375:1014–28.PubMedCrossRefGoogle Scholar
  58. 58.
    Gowing LR, Hickman M, Degenhardt L. Mitigating the risk of HIV infection with opioid substitution treatment. Bull World Health Organ. 2013;91:148–9.PubMedCentralPubMedCrossRefGoogle Scholar
  59. 59.
    MacArthur GJ, Minozzi S, Martin N, et al. Opiate substitution treatment and HIV transmission in people who inject drugs: systematic review and meta-analysis. BMJ. 2012;345:e5945.PubMedCentralPubMedCrossRefGoogle Scholar
  60. 60.
    Naar-King S, Parsons JT, Johnson AM. Motivational interviewing targeting risk reduction for people with HIV: a systematic review. Curr HIV AIDS Rep. 2012;9:335–43.CrossRefGoogle Scholar
  61. 61.
    Lorimer K, Kidd L, Lawrence M, McPherson K, Cayless S, Cornish F. Systematic review of reviews of behavioural HIV prevention interventions among men who have sex with men. AIDS Care. 2013;25:133–50.PubMedCrossRefGoogle Scholar
  62. 62.
    Gurman TA, Rubin SE, Roess AA. Effectiveness of mHealth behavior change communication interventions in developing countries: a systematic review of the literature. J Health Commun. 2012;17 Suppl 1:82–104.PubMedCrossRefGoogle Scholar
  63. 63.
    Parkhurst JO. HIV prevention, structural change and social values: the need for an explicit normative approach. J Int AIDS Soc. 2012;15(1):1–10.PubMedCrossRefGoogle Scholar
  64. 64.
    Vermund SH, Tique JA, Cassell HM, Pask ME, Ciampa PJ, Audet CM. Translation of biomedical prevention strategies for HIV: prospects and pitfalls. J Acquir Immune Defic Syndr. 2013;63 Suppl 1:S12–25.PubMedCrossRefGoogle Scholar
  65. 65.
    Vermund SH, Hayes RJ. Combination prevention: new hope for stopping the epidemic. Curr HIV AIDS Rep. 2013;10:169–86.CrossRefGoogle Scholar
  66. 66.
    Chang LW, Serwadda D, Quinn TC, Wawer MJ, Gray RH, Reynolds SJ. Combination implementation for HIV prevention: moving from clinical trial evidence to population-level effects. Lancet Infect Dis. 2013;13:65–76.PubMedCentralPubMedCrossRefGoogle Scholar
  67. 67.
    Hayes R, Sabapathy K, Fidler S. Universal testing and treatment as an HIV prevention strategy: research questions and methods. Curr HIV Res. 2011;9:429–45.PubMedCentralPubMedCrossRefGoogle Scholar
  68. 68.
    Kurth AE, Celum C, Baeten JM, Vermund SH, Wasserheit JN. Combination HIV prevention: significance, challenges, and opportunities. Curr HIV AIDS Rep. 2011;8:62–72.CrossRefGoogle Scholar
  69. 69.
    Smith K, Powers KA, Kashuba AD, Cohen MS. HIV-1 treatment as prevention: the good, the bad, and the challenges. Curr Opin HIV AIDS. 2011;6:315–25.PubMedCentralPubMedGoogle Scholar
  70. 70.
    Burns DN, Dieffenbach CW, Vermund SH. Rethinking prevention of HIV type 1 infection. Clin Infect Dis. 2010;51:725–31.PubMedCentralPubMedCrossRefGoogle Scholar
  71. 71.
    Bowser D, Sparkes SP, Mitchell A, et al. Global Fund investments in human resources for health: innovation and missed opportunities for health systems strengthening. Health Policy Plan. 2013. [Epub ahead of print]. doi: 10.1093/heapol/czt080. PubMed PMID: 24197405.
  72. 72.
    Goosby E, Dybul M, Fauci AS, et al. The United States President's Emergency Plan for AIDS Relief: a story of partnerships and smart investments to turn the tide of the global AIDS pandemic. J Acquir Immune Defic Syndr. 2012;60 Suppl 3:S51–6.PubMedCrossRefGoogle Scholar
  73. 73.
    El-Sadr WM, Holmes CB, Mugyenyi P, et al. Scale-up of HIV treatment through PEPFAR: a historic public health achievement. J Acquir Immune Defic Syndr. 2012;60 Suppl 3:S96–104.PubMedCentralPubMedCrossRefGoogle Scholar
  74. 74.
    April MD, Wood R, Berkowitz BK, et al. The survival benefits of antiretroviral therapy in South Africa. J Infect Dis. 2014;209:491–9.PubMedCentralPubMedCrossRefGoogle Scholar
  75. 75.
    Vermund SH. Massive benefits of antiretroviral therapy in Africa. J Infect Dis. 2014;209:483–5.PubMedCrossRefGoogle Scholar
  76. 76.
    Vermund SH, Sidat M, Weil LF, Tique JA, Moon TD, Ciampa PJ. Transitioning HIV care and treatment programs in southern Africa to full local management. AIDS. 2012;26:1303–10.PubMedCentralPubMedCrossRefGoogle Scholar
  77. 77.
    Hull MW, Wu Z, Montaner JS. Optimizing the engagement of care cascade: a critical step to maximize the impact of HIV treatment as prevention. Curr Opin HIV AIDS. 2012;7:579–86.PubMedCrossRefGoogle Scholar
  78. 78.
    Schouten EJ, Jahn A, Ben-Smith A, et al. Antiretroviral drug supply challenges in the era of scaling up ART in Malawi. J Int AIDS Soc. 2011;(Suppl 1):S4.Google Scholar
  79. 79.
    Boyer S, Clerc I, Bonono CR, Marcellin F, Bilé PC, Ventelou B. Non-adherence to antiretroviral treatment and unplanned treatment interruption among people living with HIV/AIDS in Cameroon: individual and healthcare supply-related factors. Soc Sci Med. 2011;72:1383–92.PubMedCrossRefGoogle Scholar
  80. 80.
    Pasquet A, Messou E, Gabillard D, et al. Impact of drug stock-outs on death and retention to care among HIV-infected patients on combination antiretroviral therapy in Abidjan, Côte d'Ivoire. PLoS One. 2010;5:e13414.PubMedCentralPubMedCrossRefGoogle Scholar
  81. 81.
    Muhamadi L, Nsabagasani X, Tumwesigye MN, et al. Inadequate pre-antiretroviral care, stock-out of antiretroviral drugs and stigma: policy challenges/bottlenecks to the new WHO recommendations for earlier initiation of antiretroviral therapy (CD <350 cells/microL) in eastern Uganda. Health Policy. 2010;97:187–94.PubMedCrossRefGoogle Scholar
  82. 82.
    Tankwanchi ABS, Özden C, Vermund SH. Physician emigration from sub-Saharan Africa to the United States: analysis of the 2011 AMA Physician Masterfile. PLoS Med. 2013;10:e1001513.PubMedCentralPubMedCrossRefGoogle Scholar
  83. 83.
    Pettifor A, Bekker LG, Hosek S, et al. Preventing HIV among young people: research priorities for the future. J Acquir Immune Defic Syndr. 2013;63 Suppl 2:S155–60.PubMedCrossRefGoogle Scholar
  84. 84.
    Vermund SH, Narayan KMV, Glass RI. Non-communicable diseases in HIV Survivors. Sci Transl Med. 2014; [In press]Google Scholar
  85. 85.
    Oluwole D, Kraemer J. Pink Ribbon Red Ribbon. Innovative public-private partnership: a diagonal approach to combating women's cancers in Africa. Bull World Health Organ. 2013;91:691–6.PubMedCentralPubMedCrossRefGoogle Scholar
  86. 86.
    Sahasrabuddhe VV, Parham GP, Mwanahamuntu MH, Vermund SH. Cervical cancer prevention in low- and middle-income countries: feasible, affordable, essential. Cancer Prev Res. 2012;5:11–7.CrossRefGoogle Scholar
  87. 87.•
    Dionne KY, Gerland P, Watkins S. AIDS exceptionalism: another constituency heard from. AIDS Behav. 2013;17:825–31. The authors’ qualitative research suggests Malawians value many other issues ahead of HIV care. Google Scholar
  88. 88.
    Emanuel EJ. PEPFAR and maximizing the effects of global health assistance. JAMA. 2012;307:2097–100.PubMedGoogle Scholar
  89. 89.
    Leach-Kemon K, Chou DP, Schneider MT, Tardif A, Dieleman JL, Brooks BP, et al. The global financial crisis has led to a slowdown in growth of funding to improve health in many developing countries. Health Aff. 2012;31:228–35.CrossRefGoogle Scholar
  90. 90.
    Schneider K, Garrett L. The end of the era of generosity? Global health amid economic crisis. Philos Ethics Humanit Med. 2009;4:1.PubMedCentralPubMedCrossRefGoogle Scholar
  91. 91.
    Holmes CB, Blandford JM, Sangrujee N, et al. PEPFAR's past and future efforts to cut costs, improve efficiency, and increase the impact of global HIV programs. Health Aff. 2012;31:1553–60.CrossRefGoogle Scholar
  92. 92.
    Grépin KA. HIV donor funding has both boosted and curbed the delivery of different non-HIV health services in sub-Saharan Africa. Health Aff. 2012;31:1406–14.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.Department of PediatricsVanderbilt University School of MedicineNashvilleUSA
  2. 2.Vanderbilt Institute for Global HealthNashvilleUSA

Personalised recommendations