Udjo Eric O
Bureau of Market Research, University of South Africa, South Africa.
Curr HIV Res. 2008 Mar;6(2):143-51. doi: 10.2174/157016208783884994.
Since the outbreak of the HIV epidemic in the 1980s, various organisations and researchers have produced statistics on HIV/AIDS including HIV prevalence, incidence, number of AIDS cases, AIDS-related mortality as well as life expectancy at birth in the context of HIV/AIDS. Until recently HIV-prevalence statistics as well as models projecting the impact of HIV/AIDS utilised HIV-prevalence statistics based on women attending antenatal clinics as population-based prevalence statistics were non-existent. Among others, the extrapolation of HIV-prevalence statistics from surveillance sites to the general population has been questioned. Recent statistics on HIV-prevalence from population-based surveys strongly suggest that HIV-prevalence in many countries may not be as high as earlier estimated and projected. In addition, model estimates of HIV/AIDS-prevalence and impact on mortality often use conventional model life tables such as the Coale-Demeny Regional, UN, and Brass standard life tables, which in the case of South Africa give female life expectancy at birth plummeting from about 65 years in the mid-1990s to around 49-50 years in 2005. The standard life tables often employed in these estimates do not take account of the 'hump' in the mortality curve due to AIDS-related deaths as these standard mortality schedules were developed prior to the HIV/AIDS epidemic. Given this background, this paper provides a critical look at recent statistics on infant mortality rates and life expectancies at birth in the context of HIV/AIDS in parts of Southern and Eastern Africa with particular reference to South Africa.
自20世纪80年代艾滋病病毒疫情爆发以来，各种组织和研究人员都公布了有关艾滋病毒/艾滋病的统计数据，包括艾滋病毒流行率、发病率、艾滋病病例数、与艾滋病相关的死亡率以及在艾滋病毒/艾滋病背景下的出生时预期寿命。直到最近，由于基于参加产前诊所的妇女的艾滋病毒流行率统计数据不存在，所以艾滋病毒流行率统计数据以及预测艾滋病毒/艾滋病影响的模型都采用了此类数据作为基于人群的流行率统计。其中，将监测点的艾滋病毒流行率统计数据外推至普通人群的做法受到了质疑。基于人群调查的最新艾滋病毒流行率统计数据有力地表明，许多国家的艾滋病毒流行率可能没有早期估计和预测的那么高。此外，艾滋病毒/艾滋病流行率及其对死亡率影响的模型估计通常使用传统的模型生命表，如科尔-德梅尼地区生命表、联合国生命表和布拉斯标准生命表，就南非而言，这些生命表得出的出生时女性预期寿命从20世纪90年代中期的约65岁骤降至2005年的49 - 50岁左右。这些估计中经常使用的标准生命表没有考虑到由于与艾滋病相关的死亡导致的死亡率曲线中的“驼峰”，因为这些标准死亡率表是在艾滋病毒/艾滋病疫情之前制定的。鉴于此背景，本文批判性地审视了南部和东部非洲部分地区在艾滋病毒/艾滋病背景下的婴儿死亡率和出生时预期寿命的最新统计数据，特别提及了南非。
