Subnational trends and regional disparities in HIV burden among reproductive-age women in Ethiopia, 1990-2023: Analysis of global burden of diseases 2023 estimates
Anteneh Berhane, Abraham Lomboro, Hiwot Hailu Amare, Teshome Gensa, Admasu Haile Hantalo, Melese Chego Cheme, Sina Temesgen, Abadi Hailay Atsbaha, Yemane Berhane Tesfau, Embaba Tekelaye Welesemayat, Embay Amare Alemseged, Yonas Angaw, Alqeer Aliyo, Kebebew Lemma, Tibeso Gemechu, Girma Ashenafi, Debela Tsegaye, Abdulbasit Sherfa, Jemal Bedewi, Sebsibe TadesseObjective
The aim of this study was to estimate the age standardized rate of prevalence, incidence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs) due to Human Immune Deficiency (HIV) among reproductive-age women in Ethiopia from 1990 to 2023.
Methods
This study is a secondary analysis of publicly available estimates from the Global Burden of Disease (GBD) 2023 study. Age-standardized estimates of prevalence, incidence, mortality, YLLs, YLDs, and DALYs rate were extracted for Ethiopian women aged 15-49 years. Analyses were conducted at national and subnational levels across all regions of Ethiopia. Temporal patterns and regional variations were assessed using GBD point estimates and corresponding 95% uncertainty intervals (UIs), without additional statistical modelling.
Results
In 2023, HIV remained a substantial public health burden among Ethiopian women of reproductive age. The age-standardized prevalence rate was 1,105.9 per 100,000 women (95% UI: 871.3-1,385.8), while age-standardized incidence and mortality rates were 46.7 (95% UI: 24.3-82.0) and 32.2 (95% UI: 20.1-49.9) per 100,000 women, respectively. Corresponding age-standardized YLL, YLD, and DALY rates were 1,718.9, 148.7, and 1,867.5 per 100,000 women, respectively. Regional variation was observed, with Gambella and Addis Ababa having the highest point estimates and the Somali Region the lowest. Between 1990 and 2023, national age-standardized incidence, mortality, YLL, YLD, and DALY rates declined slightly, whereas regional point estimates showed varied temporal patterns, including increases in several regions.
Conclusion
HIV remains a major public health challenge among Ethiopian women of reproductive age, with marked and persistent regional heterogeneity. Despite improvements in some burden indicators over time, disparities across regions highlight the need for targeted, context-specific prevention, expanded testing, and sustained treatment coverage to accelerate progress toward HIV control.