Related Experiment Video
Updated: Jan 2, 2026
Comprehensive & Cost Effective Laboratory Monitoring of HIV/AIDS: an African Role Model
Published on: October 31, 2010
Updates to the Spectrum/AIM model for estimating key HIV indicators at national and subnational levels
John Stover1, Robert Glaubius, Lynne Mofenson
1aAvenir Health, Glastonbury, Connecticut bElizabeth Glaser Pediatric AIDS Foundation, Washington DC cMedical Practice Evaluation Center and Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, USA dCentre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, South Africa eIndiana University Fairbanks School of Public Health, Indianapolis, Indiana, USA.
Background:
The Spectrum/AIM model is used by national programs and UNAIDS to prepare annual estimates of the status of the HIV epidemic in 170 countries. The model and assumptions are updated regularly under the guidance of the UNAIDS Reference Group on Estimates, Modelling and Projections in response to new data, studies and program needs. This article describes the most recent updates for the 2018 round of estimates.
Methods:
New data on AIDS-related mortality from Europe and Brazil have been used to update mortality rates of those not on antiretroviral therapy (ART). Household survey data and new studies of pregnant women, mothers, and children have been used to improve estimates of the number of HIV-positive pregnant and breastfeeding women and pediatric ART initiation. New tools to estimate geographic variation in HIV prevalence have been used to prepare district estimates of key indicators.
Results:
The 2018 version of Spectrum includes: new estimates of non-ART AIDS-related mortality by CD4 count that depend on ART coverage; a procedure to estimate country-specific patterns of HIV incidence by age by fitting to prevalence by age from household surveys; an updated estimate of postpartum transmission with ART started before pregnancy of 0.023% per month; an updated estimate of retention on treatment at delivery of 80% for all women on ART; a somewhat older pattern of ART initiation by age that has 26% of new pediatric patients initiating ART at 10-14 years of age, 18% at 2-4 years of age, and 26% at 5-9 years of age; and a new tool for estimating key HIV indicators at the district level.
Conclusion:
The new methods and data implemented in the 2018 version of Spectrum allow national programs more flexibility in describing their programs and are intended to improve the estimates of adult mortality and pediatric HIV indicators.
