Improving pediatric HIV estimates in Brazil with empirical data

Abstract

Despite the availability of methods to prevent vertical transmission of HIV to children, each year there are many pediatric cases of HIV globally. This represents a new generation of people living with HIV, whose odds of surviving until adulthood improve in tandem with treatments for HIV. Estimating burden amongst this age group is not necessarily straightforward; while some countries have Early Infant Diagnosis data available, it is often plagued by underreporting. To combat this, we used Brazil’s thorough disease surveillance systems and high quality vital registration to refine maternal prevalence estimates and from this, estimates of mortality and morbidity in children under five. Our analysis found that this approach can be integrated within the Spectrum modeling framework, and that doing so reduces the difference between modeled estimates of disease burden and case report data for children under five. This work provides a platform to continue refining estimates in pediatric HIV burden.