Report
Estimations and Projections of HIV Epidemic
Chisinau, 2010
Outline
1.
2.
3.
4.
5.
EPP2009v data input process
Spectrum V3 data input process
EPP
Spectrum 2009 output data.
Limitations and concerns
1. EPP2009v data input process
EPP2009v and Spectrum v3 are epidemiological software for the estimation of prevalence and incidence trends over
time. Taking into account the definition of epidemics provided in the EPP2009v software manual, Republic of Moldova
has a Concentrated Epidemic pattern, as all criteria below apply:



HIV has spread rapidly in at least one defined sub-population, but is not well-established in the general
population. Most often more than one subpopulation at higher risk is affected.
HIV prevalence is consistently over 5% in at least one defined subpopulation. HIV prevalence is below 1% in
pregnant women in urban areas.
This epidemic state usually suggests active networks of risk exist within and between the sub-populations.
(UNAIDS Reference group on Estimates, Modeling and Projections, 2009)
First there was a dataset created in EPP, using the recommendations from the manual; Republic of Moldova template ,
with a population, age 15+, of 2,996,180 in 2009, has been selected for the creation of the working file. and the
concentrated epidemic pattern was selected. Although there is a possibility to change the population in EPP2009v, the
national technical team has opted for entering the data and producing estimates only for the Right Bank of Dniester river
due to data quality and availability issues where the left bank is concerned (for example, there are no estimates of sizes
of populations most at risk for the left bank of Dniester river in the Republic of Moldova). Based on the data available, 4
subpopulations were created for mapping the epidemic patterns (Table 1). Data related to HIV prevalence among clients
of FSW and migrants, groups that, according to anecdotal evidence, may play an important role in determining the
epidemic, are missing:
Table 1 General characteristics of sub-population used for EPP2009v
IDU
MSM
CSW
General Population
25000
2200
6000
2 962 980
Proportion of male (0 to 1)
0.8
1
0
0.472
Excess mortality in IDUs %/year
1.07
Average time spent in group
10.4
13.1
6.7
50
15 + Population Size
The subpopulations are further defined below:
IDU – the risk group of injecting drug users, with an estimated size of 25 000 on the right bank of the Nistru river, Republic
of Moldova, with the proportion of male to female of 0.8, an excess mortality in IDUs of 1.07% per year, and the average
time spent in group of 10.4 years. Following the recommendation from the EPP2009v manual, the option of risk turnover
was selected and the prevalence in this risk group was added to the General Population prevalence (UNAIDS Reference
group on Estimates, Modelling and Projections, 2009). In the HIV data page, the routine statistics data on prevalence
among IDU registered at the Republican Narcological Dispensary, who are tested as a recommended general practice
twice per year, was entered for 1995 – 2009 years (Table 2).
MSM – the risk group of men who have sex with men, with an estimated number of 2 200 on the right bank of the Nistru
river, Republic of Moldova, with the proportion of male to female of 1.0, and an average time spent in the risk group of
13.1 years. The option of risk turnover was selected and the resulted prevalence from this subpopulation was added to
the prevalence in the General Population. In the HIV data page the prevalence among MSM was entered, the sources of
data being the Behavioral Surveillance Surveys 2003/2004 and 2007 (Table 3). As data points are few, and due to small
sample sizes the margins of error are substantive, we chose to set a maximum cap on prevalence in 2015 at 5 % (in the
2
advanced options of the Project tab) to avoid an over-inflation of the epidemic in Moldova and a disproportionate
contribution of MSM.
CSW – Commercial Sex Workers risk group, with an estimated number of 6 000 on the right bank of the Nistru river,
Republic of Moldova, the proportion of male to female of 0.0, and an average time spent in the risk group of 6.7 years.
The turnover option was selected and replace prevalence option to the general population was selected (this indicates
that some of the HIV+ individuals in the target population, assumed to come from former at-risk group, may be captured in
prevalence estimations for the general population; in the case of Republic of Moldova, some ex-CSWs may have been
captured in the antenatal care prevalence data). In the HIV data page, the prevalence among CSW was entered, the
sources of data being the Behavioral Surveillance Surveys 2003/2004 and 2007 (Table 4).
General Population – the remaining low risk population of 2 962 980, from the right bank of the Nistru river, Republic of
Moldova, the proportion of male to female being 0.472, and the average time spent in group -= 50 years (the maximum
value for EPP; life expectancy in Moldova being 69 years, the respective average duration in group is largely consistent
with the population 15+ EPP is working with). HIV data entered for this sub-population was the prevalence among
pregnant women (ANC data of women tested HIV+ during their pregnancy and women that became pregnant knowing
their HIV+ status, from the right bank of Nistru river, Republic of Moldova for 2000 – 2009 years) (Table 5).
The ART treatment data was entered for the right bank of Nistru river, Republic of Moldova; in setting targets for 2015,
the enrolment in treatment targets for 2010 – 2012, specified in the grants funded by the Global Fund fighting
AIDS/Tuberculosis and Malaria, were taken into account. The data on enrollment of MARPs in treatment has limitations,
as currently in Moldova records are kept of PLHIV on ART, disaggregated by mode of transmission rather then by
belonging to a risk group; hence data on IDU on treatment are available, and with some limitations due to underreporting,
data on MSM on treatment are available. The enrollment of CSW has been estimated based on other MARPS, using the
following formula: the share of MARPS on treatment out of MARPs that are HIV+. The same proportions of coverage of
subpopulations with treatment existent in 2008-2009 have been extrapolated until 2015. (Table 6)
In the “Survey data” page, the information regarding the prevalence among IDUs was entered for 2001, 2007 and 2009
from the Behavioral Surveillance Surveys held in the respective years, to enhance the precision of national projection and
to complement the routine statistics which are not fully representative of the whole IDU population. This data was used
afterwards for the calibration of prevalence-incidence curves of the given risk group. For the remaining sub-populations,
there was no information added in this page, because the prevalence data from BSS surveys were used as baseline HIV
prevalence data (Table 7).
In the projection page, the analysis were made for every sub-population; the projections were made using the “National
Projection” option (1900 unique curves) and were fitted to the data available. In the advanced options, the t0 has been
adjusted to better reflect the onset fo the epidemic. In the case of MSM, in the advanced options prevalence has been
limited at 5% in 2015 to avoid an over-estimation of prevalence due to limited data availability and quality issues.
In the calibration page:
IDU – the trend was calibrated to the results of the surveys in order to be adjusted to the prevalence found in the BSS
Surveys (at the moment there are no other estimates of prevalence among IDU made in Republic of Moldova)
MSM – no adjustments were made
CSW – no adjustments were made
General Population – the trend was scaled down by the factor of 0.6 (as recommended by EAD unit, UNAIDS HQ)
because usually ANC data overestimate the prevalence in the General Population.
After that the projections were made in EPP and Spectrum output file was created in order to import the incidence
estimated by EPP2009v into Spectrum.
3
2. Spectrum V3 data input process
The default data file was created based on the template for the Republic of Moldova which contains the demographic
information for the population of the Republic of Moldova. The population in Spectrum is estimated at 3 921 323; the
National Bureau of Statistics of the Republic of Moldova report the total population at 3 572 703 on the right bank of
Nistru. The difference in about 350.000 accounts for the popualiton on the left bank of Nistru – Transnistria region. While
EPP default popualiton can be amended, since estimate size of subpopulations for the left bank of Nistru is missing, we
opted for producing estimates representative only for the righ bank of Nistru in EPP2009v. Because EPP2009v calculates
the incidence in proportions, it was assumed that the incidence distribution for the right bank is similar to the incidence
distribution for the left bank and was applied for both banks (the demographic pattern in Spectrum) (Stover, 2009).
The steps made for the projections were as follows:
1) In the Epidemiology section, the HIV incidence for 15 – 49 years was imported from EPP2009v (Table 8),
2) In the HIV Age Distribution Page of AIM, there was selected the pattern for Concentrated IDU epidemic pattern,
3) In the MTCT Page there were entered the data regarding:
a) Distribution of HIV+ pregnant women by treatment regimen (Table 9)
b) Distribution of HIV+ pregnant women by infant feeding method (Table 10)
c) Percent of pregnancies of HIV+ women terminated by abortion (Table 11)
4) In the ART Treatment Page there were entered the data regarding:
a) Number of adults in need for ART receiving ART: The information was imported from EPP2009v and adjusted to
data for both banks (In EPP2009v the data regarding ART Treatment only for the right bank was entered). The
enrollment targets in ART treatment of Global Fund to fight Tuberculosis, AIDS and Malaria were entered till 2012
and the option “Linear projection of past 3 years” was used with 2010 as initial point. (Table 12).
5) In the Child Treatment section there were entered the data regarding:
a) The number of children (0 – 15) who received ART (Table 13)
b) The number of children (0 – 15) who received cotrimoxazole (Table 13)
c) The percentage of infants diagnosed with PCR (Table 14)
6) In the Treatment Cost Section in AIM there were entered the data regarding:
a) Treatment costs per patient per year (Table 15)
b) Service delivery costs (per in-patient day / out-patient visit), (Table 16)
c) Service delivery requirements (per patient per year) (Table 17)
7) In the Impacts Section there were entered the data regarding (Table 18):
a) TB incidence without HIV (per 1000)
b) Percent pop with latent TB
c) TB incidence with HIV (%)
After the data were entered, the Uncertainty Analysis in Spectrum with 1,000 curves were made.
4
Annex 1
Table 2 Prevalence among officially registered IDU (1995 - 2009 Years)
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
Median Prevalence
0.1
2.3
15.4
20.4
22.3
19.9
20.5
19.3
19.2
20.9
17.2
16.3
12.6
24.9
25.2
Mean Prevalence
0.1
2.3
15.4
20.4
22.3
19.9
20.5
19.3
19.2
20.9
17.2
16.3
12.6
24.9
25.2
National (%)
0.1
2.3
15.4
20.4
22.3
19.9
20.5
19.3
19.2
20.9
17.2
16.3
12.6
24.9
25.2
1350 1725 2098 2916
(N)
Source: Republican Narcological Dispensary
3240
3492
3954
4336
4523
4456
4555
4465
4827
3444
3354
Table 3 Prevalence among MSM (1995 – 2009 years)
2002
2003
2004
2005
2006
2007
2008
2009
Median Prevalence
-
1.7
2.5
-
-
4.8
-
-
Mean Prevalence
-
1.7
2.5
-
-
4.8
-
-
Chisinau (%)
-
1.7
2.5
4.8
-
-
118
121
83
(N)
Source: National Centre of Health Management, BSS Surveys 2003/2004, 2007
-
-
Table 4 Prevalence among CSW (1995 - 2009)
2003
2004
2005
2006
2007
2008
2009
2010
Median Prevalence
4.6
8.5
-
-
2.9
-
-
-
Mean Prevalence
4.6
8.5
-
-
10.87
-
-
-
Chisinau (%)
4.6
8.5
-
-
2.9
-
-
-
(N)
150
151
-
-
243
-
-
-
-
-
-
-
32.8
-
-
-
122
(N)
Source: National Centre of Health Management, BSS Surveys 2003/2004, 2007
-
-
Balti (%)
5
Table 5 HIV prevalence among general population (2000 – 2009)
2000 2001 2002 2003
2004
2005
2006
2007
2008
2009
Median Prevalence
0
0
0
0
0.05
0.08
0.1
0.13
0.16
0.15
Mean Prevalence
0
0
0
0
0.11
0.11
0.15
0.13
0.22
0.2
Chișinău (%)
0
0
0
0
0.05
0.08
0.1
0.13
0.16
0.15
975
2218
4586
10868
13018
10578
11553
13182
13918
13410
Bălti (%)
-
-
-
-
0.53
0.37
0.63
0.25
0.72
0.81
(N)
-
-
-
-
1502
1615
1903
1982
2217
2104
Anenii - Noi (%)
-
-
-
-
0
0.11
0.4
0.09
0
0.21
(N)
-
-
-
-
849
894
1009
1047
1098
970
Basarabeasca (%)
-
-
-
-
0
0
0.33
0.76
0.83
0.36
(N)
-
-
-
-
167
251
304
263
240
275
Briceni (%)
-
-
-
-
0
0
0
0.23
0
0
(N)
-
-
-
-
276
518
541
871
672
766
Cahul (%)
-
-
-
-
0.11
0
0.34
0
0.12
0.31
(N)
-
-
-
-
926
1223
1755
1540
1708
1297
Cantemir (%)
-
-
-
-
0.31
0
0.14
0
0.13
0.26
(N)
-
-
-
-
325
557
711
690
761
767
Calarasi (%)
-
-
-
-
0.12
0
0
0
0
0
(N)
-
-
-
-
839
832
775
668
696
830
Causeni (%)
-
-
-
-
0.32
0.14
0.11
0.22
0.51
0.2
(N)
-
-
-
-
630
691
917
927
988
1018
Cimislia (%)
-
-
-
-
0
0
0.19
0.42
0
0
(N)
-
-
-
-
586
585
523
479
491
575
Criuleni (%)
-
-
-
-
0.27
0.13
0.11
0.31
0.19
0.28
(N)
-
-
-
-
372
772
887
954
1081
1075
Donduseni (%)
-
-
-
-
0.29
0.22
0
0
0
0
(N)
-
-
-
-
350
446
403
437
340
399
Drochia (%)
-
-
-
-
0.16
0
0
0.18
0.27
0.33
(N)
-
-
-
-
629
789
900
541
743
916
Edinet (%)
-
-
-
-
0.17
0
0.12
0.1
0.25
0
(N)
-
-
-
-
582
1107
849
960
806
906
Falesti (%)
-
-
-
-
0.17
0.14
0.25
0
0.53
0.29
(N)
-
-
-
-
591
734
797
782
950
1020
Floresti (%)
-
-
-
-
0.17
0.13
0
0.12
0.36
0
(N)
-
-
-
-
595
780
800
826
832
908
Glodeni (%)
-
-
-
-
0.14
0
0
0
0.42
0.49
(N)
-
-
-
-
691
633
547
642
710
612
Hincesti (%)
-
-
-
-
0
0.08
0.07
0.29
0.15
0
(N)
-
-
-
-
883
1315
1400
1394
1308
1349
Ialoveni (%)
-
-
-
-
0
0
0.16
0.16
0.25
0.14
(N)
-
-
-
-
1146
1186
1213
1258
1187
1449
Leova (%)
-
-
-
-
0
0
0.45
0
0.18
0
(N)
-
-
-
-
108
372
449
484
542
513
Nisporeni (%)
-
-
-
-
0
0
0.13
0
0
0
(N)
-
-
-
-
402
778
782
691
625
754
Ocnita (%)
-
-
-
-
0.93
0
0.26
0.23
0
1.24
(N)
-
-
-
-
215
361
387
431
400
403
(N)
6
Orhei (%)
-
-
-
-
0
0.27
0
0.13
0.25
0.17
(N)
-
-
-
-
1775
1501
1515
1555
1605
1777
Rezina (%)
-
-
-
-
0
0
0
0
0.24
1.45
(N)
-
-
-
-
233
405
394
492
417
276
Riscani (%)
-
-
-
-
0.45
0.38
0.14
0.14
0.14
0
(N)
-
-
-
-
441
786
739
715
690
704
Singerei (%)
-
-
-
-
0.16
0.35
0.33
0.45
0.36
0.25
(N)
-
-
-
-
625
867
1224
1110
1104
1201
Soroca (%)
-
-
-
-
0.15
0.11
0.1
0
0.2
0
(N)
-
-
-
-
670
881
956
975
1012
1007
Straseni (%)
-
-
-
-
0.25
0.12
0
0
0.29
0.39
(N)
-
-
-
-
794
817
1041
1026
1045
1020
Soldanesti (%)
-
-
-
-
0
0
0
0
0.19
0
(N)
-
-
-
-
341
305
392
382
532
472
Stefan Voda (%)
-
-
-
-
0.17
0
0.37
0
0.13
0
(N)
-
-
-
-
584
537
816
777
774
752
Taraclia (%)
-
-
-
-
0.46
0.45
0
0
0.19
0
(N)
-
-
-
-
220
444
482
494
533
523
Telenesti (%)
-
-
-
-
0
0.24
0.12
0.17
0.28
0
(N)
-
-
-
-
662
827
811
589
717
729
Ungheni (%)
-
-
-
-
0
0.09
0.17
0.16
0.26
0.2
(N)
-
-
-
-
688
1086
1207
1241
1523
1514
Comrat (%)
-
-
-
-
0.3
0.11
0
0.11
0.32
0.3
(N)
-
-
-
-
660
903
1082
924
1248
1007
Ceadir Lunga (%)
-
-
-
-
0
0.17
0
0.12
0
0.11
(N)
-
-
-
-
516
588
634
808
728
883
Vulcanesti (%)
-
-
-
-
0
0
0
0
0.29
0
(N)
-
-
-
-
10
230
268
290
344
348
Centrul SIDA (%)
-
-
-
-
0
0
0
0
0
-
(N)
-
-
-
-
36
90
140
216
190
-
Source: National Centre of Preventive Medicine, AIDS Centre. HIV prevalence among pregnant women tested during the
years 2000 to 2009.
7
Table 6 ART Treatment data for 2003 – 2009 (includes the estimations till 2015), Republic of Moldova
2003
2004
2005
2006
2007
2008
2009
First year survival on ART
Percent surviving 1st year of
ART (%)
National adult ART coverage
Number of adults on ART
Number of adults on ART
Distribution of ART among
sub-populations
IDU
MSM
Sex workers
General Population
Distribution of ART among
sub-populations
IDU
MSM
Sex workers
General Population
1-st line
2-nd line
TOTAL
Number
1-st line
1-st line
1-st line
1-st line
Number
2-nd line
2-nd line
2-nd line
2-nd line
2010
2011
2012
2013
2014
2015
0
50
50
60
81
76
88
88
88
88
88
88
88
19
0
19
90
0
90
171
2
173
247
4
251
471
10
481
629
24
653
711
31
742
828
131
959
944
230
1174
1061
330
1391
1177
430
1607
1294
529
1823
1410
629
2039
14
1
0
4
57
2
6
25
82
6
10
73
113
8
14
112
217
9
27
218
300
9
36
284
310
12
39
350
370
16
46
396
431
20
52
441
490
25
59
487
551
29
65
532
611
33
72
578
672
37
78
623
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
4
3
0
0
7
4
1
0
19
5
2
1
23
54
3
7
67
103
4
13
110
153
6
19
152
202
7
24
197
250
8
30
241
300
9
36
284
Table 7 HIV prevalence among IDU’s used for calibration
% HIV
Year
Standard error
Sample size
Survey
29.23%
2001
4.20%
543
1
Survey
21.00%
2007
4.17%
552
2
Survey
21.00%
2009
2.81%
663
3
Source: National Centre of Health Management, BSS Surveys 2001, 2007, 2009
Table 8 Imported HIV Incidence from EPP2009v into Spectrum v3
2000 2001 2002 2003 2004 2005 2006 2007
Incidence
0.05
0.06
0.06
0.06
0.06
0.06
0.06
0.06
2008
2009
2010
2011
2012
2013
2014
2015
0.06
0.07
0.07
0.08
0.09
0.10
0.11
0.12
8
Table 9 Distribution of HIV+ pregnant women by treatment regimen, both banks of Dniester River, Republic of Moldova
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
Single dose nevirapine
Number
0
0
0
0
0
1
0
1
0
0
0
0
0
0
0
0
Dual ARV
Number
0
0
0
4
21
4
0
0
0
0
0
0
0
0
0
0
Number
Triple ARV Treatment
0
0
0
0
10
58
62
81
129
109
150
150
180
180
180
180
Number
Total
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Number
0
0
0
4
31
63
62
82
129
109
150
150
180
180
180
180
2011
2012
Triple ARV prophylaxis
Table 10 Distribution of HIV+ pregnant women by infant feeding method, both banks of Dniester River, Republic of Moldova
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2013
2014
2015
Mixed feeding
Number
0
0
0
1
4
0
1
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
24
27
63
62
74
126
119
129
139
150
160
170
180
0
0
0
25
31
63
63
77
126
119
129
139
150
160
170
180
2012
2013
2014
2015
Exclusive breastfeeding
Number
Replacement feeding
Number
Total
Number
Table 11 Percent of pregnancies to HIV+ women terminated by abortion, both banks of Dniester River, Republic of Moldova
2000
Number
0
2001
0
2002
0
2003
0
2004
6
2005
14
2006
8
2007
17
2008
9
2009
18
2010
18
2011
19
19
19
20
20
9
Table 12 Number of adults in need for ART receiving ART, both banks of Dniester River, Republic of Moldova
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
0
0.5
0.5
0.6
0.81
0.76
0.88
0.88
0.88
0.88
0.88
0.88
0.88
19
90
171
247
471
629
909
1,172
1,435
1,698
1,961
2,224
2,487
0
0
2
4
10
24
41
55
69
83
96
110
124
Proportion surviving first year on ART
Number of adults receiving first line ART
Number of adults receiving second line ART
Table 13 Number of children (0 – 15) who received ART and Cotrimoxazole, both banks of Dniester River, Republic of Moldova
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
0
0
0
2
2
3
33
34
34
35
36
36
37
4
5
7
14
19
29
35
36
37
39
40
41
42
Number receiving
cotrimoxazole
Number Receiving
ART
Table 14 Percentage of infants diagnosed with PCR, both banks of Dniester River, Republic of Moldova
PCR
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
0
100
100
100
100
100
100
100
100
100
100
100
100
Table 15 Treatment costs per patient per year, USD
2007
2008
2009
2010
2011
2012
2013
2014
2015
823
823
823
823
823
823
823
823
823
Second line ART drugs
1,975.00
1,975.00
1,975.00
1,975.00
1,975.00
1,975.00
1,975.00
1,975.00
1,975.00
Additional ART drug costs for TB patients (male)
2,887.00
2,887.00
2,887.00
2,887.00
2,887.00
2,887.00
2,887.00
2,887.00
2,887.00
Additional ART drug costs for TB patients (Female)
2,887.00
2,887.00
2,887.00
2,887.00
2,887.00
2,887.00
2,887.00
2,887.00
2,887.00
Lab costs for ART treatment
76.2
76.2
76.2
76.2
76.2
76.2
76.2
76.2
76.2
Drug and lab costs for opportunistic infections
221
221
221
221
221
221
221
221
221
42
42
42
42
42
42
42
42
42
1,573.00
1,573.00
1,573.00
1,573.00
1,573.00
1,573.00
1,573.00
1,573.00
1,573.00
357
357
357
357
357
357
357
357
357
First line ART drugs
Cotrimoxazole prophylaxis
TB prophylaxis
Nutrition supplements in first six months
10
Table 16 Service delivery costs (per in-patient day / out-patient visit)
2008
2009
2010
2011
2012
2013
2014
2015
21
21
21
21
21
21
21
21
2
2
2
2
2
2
2
2
Cost per in-patient day
Cost per out-patient visit
Table 17 Service delivery requirements (per patient per year)
2007
2008
2009
2010
2011
2012
2013
2014
2015
ART: in-patient days
472
472
472
472
472
472
472
472
472
ART: out-patient visit
34.3
34.3
34.3
34.3
34.3
34.3
34.3
34.3
34.3
OI treatment: in-patient days
151
151
151
151
151
151
151
151
151
OI treatment: out-patient days
23
23
23
23
23
23
23
23
23
Table 18 Entered data into the “Impacts” Section
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
TB incidence without HIV (per 1000)
1.2
1.1
1
1
1.08
1.17
1.25
1.33
1.42
1.5
Percent pop with latent TB
70
70
70
70
70
70
70
70
70
70
TB incidence with HIV (%)
3.7
3.3
4.8
4.2
4.25
4.3
4.35
4.4
4.45
4.5
11
3. EPP Graphic Outputs
12
13
EPP projections for 2009-2015
Total Population
Year
2009
2010
2011
2012
2013
2014
2015
%HIV+
0.53
0.55
0.59
0.62
0.67
0.72
0.78
Num
HIV+
15,832
16,548
17,460
18,553
19,837
21,352
23,153
%HIV+
4.68
4.89
5.01
5.04
4.99
4.88
4.72
Num
HIV+
103
107
109
110
108
106
102
Population
2,996,036
2,989,234
2,982,358
2,975,326
2,968,163
2,960,896
2,953,522
IDU
%HIV+
23.37
23.5
23.69
23.92
24.1
24.21
24.3
Num
HIV+
5,843
5,806
5,772
5,728
5,659
5,572
5,479
%HIV+
12.26
10.67
9.26
8.02
6.94
6
5.19
Num
HIV+
736
639
554
480
415
358
309
MSM
Year
2009
2010
2011
2012
2013
2014
2015
Population
25,000
24,708
24,365
23,944
23,479
23,011
22,550
LSC
Population
2,200
2,192
2,185
2,177
2,169
2,162
2,154
General Population
Population
6,000
5,992
5,987
5,982
5,976
5,970
5,961
%HIV+
0.31
0.34
0.37
0.42
0.46
0.52
0.59
Num
HIV+
9,150
9,995
11,024
12,235
13,655
15,317
17,262
Population
2,962,836
2,956,341
2,949,822
2,943,223
2,936,538
2,929,754
2,922,857
14
4. Spectrum 2009 output data.
After having all the input data entered, projections made and calibrations applied, EPP was switched to the Results tab
where HIV incidence was selected.
Spectrum has generated two sets of output data, based on selected treatment eligibility criteria (CD4<200 and CD4<350).
The EPP 2009 file has been read twice for each respective projection in Spectrum. All additional input data entered in
the required sections (Epidemiology, HIV Age Distribution, MTCT, ART, etc) have been identical. Entry data has been
presented in absolute numbers; % values could not be used due to difficulties in establishing denominators
retrospectively for certain indicators. Spectrum has generated output estimations for the following:
Republic of Moldova national projections for both banks (CD4<200 / CD4<350)
1) Total HIV population
 Number of new HIV infections
 Annual AIDS deaths
2) Adults 15+
 HIV population
 New HIV infections
 HIV Incidence (15-49)
 Annual AIDS deaths
 Total need for ART treatment
 Total number receiving ART
 Number in need of first line therapy
 Number newly needing first line therapy
 Number receiving first line therapy
 Number receiving second line therapy
 Unmet need for first line therapy
 Total adult population 15+
3) Children 0-14:
 HIV population
 New HIV infections
 Annual AIDS deaths
 Total population 0-14
 Children needing cotrimoxazole
 Children receiving cotrimoxazole
 Children needing ART
 Children receiving ART
 PMTCT
 HIV Population 15-17
4) Orphans
 Maternal Orphans
 Paternal Orphans
 Double Orphans
 Total Orphans
 All AIDS Orphans
Variations have been registered in outputs depending on the treatment eligibility criteria (CD4<200 or CD4<350); while
certain projected differences like No of people in need of treatment has increased in the case of CD4<350, as expected,
other variations in annual incidence, annual deaths etc are less clear, as expectations would be to have lower annual
deaths if people enter into treatment.
The Spectrum output data was exported to the tables below:
15
HIV/AIDS Summary - Total
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
Republic of Moldova 15.04.2010 national projection for both banks CD4<350
HIV population
Total
11,160
11,823
12,407
12,870
12,964
13,146
13,356
13,608
13,922
14,300
14,825
15,525
16,344
17,295
18,399
19,681
Males
7,941
8,402
8,804
9,121
9,168
9,280
9,411
9,572
9,778
10,029
10,386
10,868
11,434
12,093
12,860
13,749
Females
3,219
3,421
3,602
3,750
3,796
3,866
3,946
4,036
4,144
4,271
4,439
4,657
4,910
5,202
5,540
5,931
0.4
0.43
0.45
0.46
0.46
0.47
0.48
0.49
0.51
0.53
0.55
0.59
0.63
0.68
0.74
0.81
1,318
1,322
1,378
1,376
1,145
1,260
1,318
1,348
1,432
1,506
1,615
1,742
1,880
2,036
2,221
2,436
Males
938
941
982
980
816
901
943
965
1,025
1,076
1,153
1,243
1,340
1,450
1,580
1,730
Females
380
381
397
395
328
358
375
383
408
429
462
499
540
586
641
705
Total
321
438
551
659
803
845
886
887
917
930
896
850
869
893
919
953
Males
237
325
408
485
592
621
650
649
668
676
650
615
627
644
661
685
83
114
143
174
211
223
236
239
249
254
246
234
242
249
258
268
Prevalence (15-49)
Number of new HIV infections
Total
Annual AIDS deaths
Females
Republic of Moldova 15.04.2010 national projection for both banks CD4<200
HIV population
Total
11,223
11,887
12,471
12,933
13,030
13,217
13,432
13,689
14,013
14,401
14,933
15,643
16,477
17,444
18,564
19,861
Males
7,966
8,426
8,827
9,139
9,190
9,305
9,438
9,601
9,813
10,070
10,428
10,911
11,482
12,146
12,918
13,812
Females
3,257
3,461
3,643
3,794
3,841
3,913
3,994
4,088
4,200
4,331
4,505
4,732
4,995
5,298
5,646
6,049
0.4
0.43
0.45
0.46
0.47
0.47
0.48
0.49
0.51
0.53
0.56
0.59
0.63
0.68
0.74
0.81
1,322
1,329
1,386
1,376
1,087
1,232
1,304
1,339
1,417
1,498
1,607
1,733
1,871
2,026
2,210
2,424
Males
938
944
985
978
774
880
931
956
1,012
1,069
1,145
1,234
1,330
1,440
1,568
1,718
Females
383
385
401
398
313
352
373
383
406
430
462
499
540
587
642
706
Total
323
441
555
656
739
808
864
868
888
908
877
825
841
861
887
919
Males
238
326
410
484
544
594
633
635
647
660
638
601
611
624
642
664
84
115
145
172
194
214
231
233
241
248
239
224
230
237
245
254
Prevalence (15-49)
Number of new HIV infections
Total
Annual AIDS deaths
Females
16
Adults 15+ Summary Total
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
Republic of Moldova 15.04.2010 national projection for both banks CD4<350
HIV population
Total
11,105
11,759
12,334
12,790
12,883
13,070
13,281
13,536
13,853
14,233
14,760
15,463
16,287
17,242
18,352
19,637
Males
7,913
8,369
8,768
9,080
9,127
9,241
9,373
9,536
9,743
9,996
10,354
10,837
11,406
12,066
12,836
13,727
Females
3,192
3,389
3,566
3,710
3,756
3,828
3,908
4,000
4,110
4,238
4,407
4,626
4,881
5,176
5,516
5,910
0.33
0.35
0.37
0.39
0.39
0.4
0.41
0.42
0.43
0.44
0.46
0.48
0.51
0.55
0.59
0.63
1,289
1,294
1,350
1,349
1,127
1,255
1,312
1,347
1,431
1,504
1,613
1,740
1,878
2,035
2,219
2,434
Males
923
926
967
967
807
899
940
964
1,024
1,076
1,153
1,242
1,339
1,449
1,579
1,729
Females
366
367
383
382
319
356
372
382
407
429
461
498
539
585
640
704
0.04
0.04
0.04
0.04
0.03
0.04
0.04
0.04
0.04
0.05
0.05
0.05
0.06
0.06
0.07
0.08
Total
305
423
536
644
791
837
880
883
914
928
894
847
867
892
918
953
Males
229
317
400
478
586
618
647
647
667
675
649
614
626
643
661
685
76
106
135
166
205
219
233
237
247
253
245
233
241
248
258
268
Total
831
1,104
1,361
3,591
3,934
4,234
4,491
4,745
4,971
5,190
5,456
5,792
6,141
6,513
6,920
7,367
Male
577
765
940
2,616
2,854
3,061
3,234
3,405
3,554
3,698
3,877
4,106
4,345
4,600
4,881
5,191
254
339
421
975
1,080
1,174
1,257
1,341
1,417
1,492
1,580
1,686
1,797
1,913
2,039
2,176
Total
0
0
0
19
90
173
251
481
653
742
1,058
1,373
1,689
2,004
2,319
2,635
Male
0
0
0
14
65
125
181
345
467
529
753
975
1,197
1,417
1,637
1,858
Female
0
0
0
5
25
48
70
136
186
213
305
398
492
587
682
777
0
0
0
0.5
2.2
4
5.4
9.9
12.9
13.9
18.8
23
26.7
29.8
32.5
35.8
Total
831
1,104
1,361
3,591
3,934
4,233
4,488
4,738
4,954
5,162
5,359
5,562
5,779
6,018
6,292
6,607
Male
577
765
940
2,616
2,854
3,060
3,232
3,400
3,541
3,678
3,807
3,941
4,087
4,248
4,436
4,654
Adult prevalence
New HIV infections
Total
Incidence (15-49)
Annual AIDS deaths
Females
Total need for ART
Female
Total number receiving
ART
Coverage (%)
Number in need of first
line therapy
17
Female
Number newly needing
first line therapy
254
339
421
975
1,080
1,173
1,256
1,339
1,413
1,484
1,552
1,621
1,692
1,770
1,856
1,953
Total
474
573
656
2,714
1,114
1,109
1,106
1,095
1,082
1,104
1,113
1,122
1,149
1,189
1,242
1,308
Male
338
409
468
2,031
810
804
799
788
777
792
798
803
822
850
888
936
137
165
188
683
304
305
307
306
305
312
315
319
327
338
354
372
Total
0
0
0
19
90
171
247
471
629
711
894
1,077
1,260
1,442
1,625
1,808
Male
0
0
0
14
65
124
178
338
450
507
635
763
891
1,018
1,146
1,274
Female
0
0
0
5
25
47
69
133
179
204
259
314
369
424
479
534
0
0
0
0.5
2.2
3.9
5.3
9.7
12.4
13.4
15.9
18.1
19.9
21.5
22.7
24.5
Total
0
0
0
0
0
2
4
10
24
31
164
296
429
562
694
827
Male
0
0
0
0
0
1
3
7
17
22
117
211
306
399
492
584
0
0
0
0
0
1
1
3
7
9
47
85
123
163
202
243
Total
831
1,104
1,361
3,582
3,879
4,103
4,279
4,379
4,404
4,492
4,556
4,577
4,610
4,667
4,759
4,890
Male
577
765
940
2,609
2,814
2,965
3,081
3,141
3,146
3,197
3,233
3,239
3,256
3,291
3,352
3,444
Female
254
339
421
973
1,065
1,138
1,198
1,239
1,258
1,295
1,323
1,338
1,354
1,376
1,406
1,447
Total
3,330,419
3,320,983
3,310,427
3,299,391
3,287,973
3,276,687
3,265,414
3,254,098
3,242,046
3,228,151
3,211,840
3,193,283
3,172,112
3,148,526
3,123,304
3,097,354
Male
1,581,635
1,578,446
1,574,467
1,569,917
1,564,780
1,559,460
1,554,005
1,548,485
1,542,671
1,536,044
1,528,246
1,519,284
1,508,883
1,497,108
1,484,384
1,471,226
Female
1,748,784
1,742,537
1,735,960
1,729,474
1,723,193
1,717,226
1,711,409
1,705,614
1,699,374
1,692,107
1,683,594
1,673,998
1,663,229
1,651,417
1,638,920
1,626,129
Female
Number receiving first
line therapy
Coverage (%)
Number receiving
second line therapy
Female
Unmet need for first line
therapy
Adult population 15+
18
Adults 15+ Summary Total
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
Republic of Moldova 15.04.2010 national projection for both banks CD4<200
HIV population
Total
11,169
11,823
12,399
12,854
12,950
13,142
13,358
13,619
13,945
14,336
14,869
15,583
16,420
17,392
18,518
19,818
Males
7,939
8,394
8,791
9,099
9,149
9,267
9,401
9,566
9,779
10,037
10,396
10,881
11,454
12,121
12,894
13,790
Females
3,230
3,429
3,608
3,754
3,801
3,875
3,957
4,053
4,166
4,299
4,474
4,702
4,967
5,272
5,623
6,028
0.34
0.36
0.37
0.39
0.39
0.4
0.41
0.42
0.43
0.44
0.46
0.49
0.52
0.55
0.59
0.64
Total
1,293
1,301
1,358
1,350
1,070
1,228
1,298
1,337
1,416
1,497
1,605
1,731
1,869
2,024
2,208
2,421
Males
924
930
971
965
765
878
928
955
1,011
1,068
1,144
1,233
1,330
1,439
1,567
1,717
Females
370
372
387
385
305
350
370
382
405
429
461
498
539
586
641
705
0.04
0.04
0.04
0.04
0.03
0.04
0.04
0.04
0.04
0.05
0.05
0.05
0.06
0.06
0.07
0.08
Total
308
426
539
641
726
800
858
864
885
906
874
823
839
859
886
918
Males
231
318
402
477
538
590
630
633
646
659
637
600
610
623
642
664
Females
77
107
137
165
188
210
228
231
240
247
238
223
229
236
244
254
Total
838
1,112
1,370
1,608
1,829
2,023
2,195
2,390
2,586
2,780
3,021
3,334
3,656
3,990
4,339
4,704
Male
580
768
944
1,104
1,251
1,379
1,492
1,622
1,753
1,881
2,041
2,251
2,467
2,692
2,925
3,169
257
344
427
504
578
644
703
769
834
899
980
1,083
1,189
1,299
1,414
1,534
Total
0
0
0
19
90
173
251
481
653
742
1,058
1,373
1,689
2,004
2,319
2,635
Male
0
0
0
13
62
118
171
326
443
502
717
930
1,143
1,355
1,567
1,779
Female
0
0
0
6
28
55
80
155
210
240
341
443
546
649
752
856
0
0
0
1.1
4.7
8.2
10.9
19.3
24.3
25.6
33.3
39.3
44.2
48.1
51.3
56
Total
838
1,112
1,370
1,608
1,829
2,022
2,192
2,383
2,569
2,752
2,924
3,104
3,293
3,495
3,711
3,943
Male
580
768
944
1,104
1,251
1,378
1,490
1,617
1,741
1,862
1,974
2,093
2,218
2,352
2,496
2,651
Adult prevalence
New HIV infections
Incidence (15-49)
Annual AIDS deaths
Total need for ART
Female
Total number receiving
ART
Coverage (%)
Number in need of first
line therapy
19
257
344
427
504
578
643
702
766
828
890
949
1,011
1,075
1,142
1,215
1,292
Total
478
577
660
727
772
797
821
828
826
861
869
868
883
904
931
966
Male
339
410
470
518
549
566
583
587
584
608
612
610
620
634
652
675
139
167
190
209
223
230
238
242
242
253
257
258
263
270
279
290
Total
0
0
0
19
90
171
247
471
629
711
894
1,077
1,260
1,442
1,625
1,808
Male
0
0
0
13
62
117
168
320
426
481
604
726
849
971
1,093
1,216
Female
0
0
0
6
28
54
79
151
203
230
290
351
411
471
532
592
0
0
0
1.1
4.7
8.1
10.8
18.9
23.4
24.5
28.1
30.8
33
34.6
35.9
38.4
Total
0
0
0
0
0
2
4
10
24
31
164
296
429
562
694
827
Male
0
0
0
0
0
1
3
7
17
21
113
204
294
385
474
563
0
0
0
0
0
1
1
3
7
10
51
92
135
177
220
264
Total
838
1,112
1,370
1,599
1,774
1,891
1,983
2,024
2,019
2,082
2,121
2,118
2,125
2,144
2,177
2,227
Male
580
768
944
1,097
1,213
1,287
1,345
1,368
1,360
1,399
1,421
1,416
1,418
1,429
1,450
1,483
Female
257
344
427
502
562
604
638
657
659
683
700
702
707
715
727
744
3,330,412
3,320,974
3,310,415
3,299,382
3,288,029
3,276,780
3,265,528
3,254,232
3,242,207
3,228,335
3,212,043
3,193,509
3,172,366
3,148,812
3,123,622
3,097,706
1,581,631
1,578,441
1,574,461
1,569,912
1,564,823
1,559,531
1,554,091
1,548,585
1,542,791
1,536,179
1,528,392
1,519,443
1,509,057
1,497,300
1,484,592
1,471,453
1,748,781
1,742,533
1,735,954
1,729,470
1,723,206
1,717,249
1,711,437
1,705,647
1,699,416
1,692,156
1,683,651
1,674,067
1,663,310
1,651,512
1,639,029
1,626,253
Female
Number newly needing
first line therapy
Female
Number receiving first
line therapy
Coverage (%)
Number receiving
second line therapy
Female
Unmet need for first line
therapy
Adult population 15+
Total
Male
Female
20
Child 0-14 Summary Total
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
Republic of Moldova 15.04.2010 national projection for both banks CD4<350
HIV population
Total
54
64
73
80
82
76
75
72
69
67
64
62
58
52
47
43
Males
28
33
37
40
41
38
38
36
35
33
32
31
29
26
24
22
Females
27
32
36
40
41
38
37
36
34
33
32
31
29
26
24
21
Total
29
28
28
27
18
5
7
2
2
1
1
2
2
2
2
2
Males
15
15
14
14
9
2
3
1
1
1
1
1
1
1
1
1
Females
14
14
14
13
9
2
3
1
1
1
1
1
1
1
1
1
Total
15
16
16
15
12
7
6
4
3
2
2
2
2
2
1
0
Males
8
8
8
8
6
4
3
2
2
1
1
1
1
1
1
0
Females
7
8
8
7
6
4
3
2
2
1
1
1
1
1
1
0
Total
979,657
930,405
877,292
825,012
778,741
738,152
703,460
674,849
651,274
632,388
618,426
609,431
605,621
605,829
608,881
613,956
Male
491,310
465,796
438,432
411,771
388,532
368,417
351,412
337,506
326,048
316,828
310,028
305,749
304,164
304,716
306,792
309,923
488,347
464,609
438,860
413,241
390,208
369,735
352,049
337,343
325,225
315,561
308,397
303,683
301,457
301,112
302,089
304,032
Total
173
181
185
188
72
62
61
54
52
51
52
51
50
47
44
40
Male
89
93
95
96
36
31
31
27
26
26
26
26
25
24
22
20
84
88
90
92
36
31
30
27
26
25
26
26
25
23
22
20
Total
0
0
0
0
0
0
2
2
3
33
34
34
35
36
36
37
Male
0
0
0
0
0
0
1
1
2
17
17
17
18
18
18
19
Female
0
0
0
0
0
0
1
1
1
16
17
17
17
18
18
18
New HIV infections
Annual AIDS deaths
Population 0-14
Female
Children needing
cotrimoxazole
Female
Children receiving
cotrimoxazole
Children needing ART
21
Total
26
30
33
35
34
30
30
30
30
33
43
44
44
42
41
42
Male
13
15
17
17
17
15
15
15
15
16
22
22
22
21
21
21
Female
13
15
16
17
17
15
15
15
15
16
22
22
22
21
20
21
Total
0
0
0
4
5
7
14
19
29
35
36
37
39
40
41
42
Male
0
0
0
2
3
4
7
10
15
18
18
19
20
20
21
21
Female
0
0
0
2
2
3
7
9
14
17
18
18
19
20
20
21
112
111
109
107
98
86
92
81
92
84
88
92
100
108
118
132
95
94
92
91
83
73
78
69
78
71
74
78
85
92
100
112
0
0
0
4
31
63
62
69
78
71
74
78
85
92
100
112
30
30
30
29
21
6
8
3
2
2
2
2
2
2
2
2
Total
20
17
17
18
16
16
17
18
19
20
22
24
29
35
42
47
Male
4
3
4
4
3
4
4
4
4
4
5
6
8
10
13
14
16
14
14
14
13
13
13
14
15
16
17
19
21
25
29
33
Children receiving ART
PMTCT
Number of HIV+
pregnant women
Mothers needing
PMTCT
Mothers receiving
PMTCT
MTCT rate
HIV population 15-17
Female
22
Child 0-14 Summary Total
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
Republic of Moldova 15.04.2010 national projection for both banks CD4<200
HIV population
Total
54
64
72
79
81
75
74
70
68
65
63
61
57
52
47
43
Males
27
32
36
40
41
38
37
35
34
33
32
30
28
26
23
21
Females
26
31
36
39
40
37
37
35
34
33
32
30
28
26
23
21
Total
28
28
28
26
17
4
6
2
2
1
1
2
2
2
2
2
Males
15
14
14
14
9
2
3
1
1
1
1
1
1
1
1
1
Females
14
14
13
13
8
2
3
1
1
1
1
1
1
1
1
1
Total
15
15
15
15
12
7
5
4
3
2
2
2
2
1
1
0
Males
8
8
8
8
6
4
3
2
2
1
1
1
1
1
0
0
Females
7
8
8
7
6
4
3
2
2
1
1
1
1
1
0
0
Total
979,657
930,406
877,293
825,013
778,742
738,154
703,464
674,854
651,280
632,395
618,434
609,440
605,631
605,840
608,894
613,970
Male
491,310
465,796
438,432
411,772
388,533
368,418
351,414
337,509
326,051
316,831
310,032
305,753
304,169
304,722
306,799
309,930
488,347
464,610
438,861
413,241
390,209
369,737
352,050
337,345
325,228
315,564
308,401
303,687
301,462
301,118
302,095
304,039
Total
171
179
183
185
71
61
59
53
51
50
51
51
49
46
43
40
Male
88
92
94
95
36
31
30
26
26
25
26
25
25
23
22
20
83
87
89
91
35
30
29
26
25
25
26
25
24
23
21
20
Total
0
0
0
0
0
0
2
2
3
33
34
34
35
36
36
37
Male
0
0
0
0
0
0
1
1
2
17
17
17
18
18
18
19
Female
0
0
0
0
0
0
1
1
1
16
17
17
17
18
18
18
New HIV infections
Annual AIDS deaths
Population 0-14
Female
Children needing
cotrimoxazole
Female
Children receiving
cotrimoxazole
Children needing ART
23
Total
25
30
33
34
34
30
29
29
30
33
43
44
43
41
41
42
Male
13
15
16
17
17
15
15
15
15
16
21
22
22
21
21
21
Female
13
15
16
17
17
15
15
15
15
16
22
22
22
21
20
21
Total
0
0
0
4
5
7
14
19
29
35
36
37
39
40
41
42
Male
0
0
0
2
3
4
7
10
15
18
18
19
20
20
21
21
Female
0
0
0
2
2
3
7
9
14
17
18
18
19
20
20
21
110
109
107
106
97
84
90
79
89
82
85
90
97
106
115
129
94
93
91
90
82
71
76
67
76
69
72
76
83
90
98
109
0
0
0
4
31
63
62
67
76
69
72
76
83
90
98
109
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Total
24
20
20
21
18
19
20
21
22
23
25
28
33
39
46
52
Male
8
7
7
7
7
7
7
8
8
9
9
10
13
16
18
21
16
13
13
13
12
12
12
13
14
15
16
18
20
24
28
31
Children receiving ART
PMTCT
Number of HIV+
pregnant women
Mothers needing
PMTCT
Mothers receiving
PMTCT
MTCT rate
HIV population 15-17
Female
24
5. Limitations and concerns
• Absolute No were used as inputs in both EPP & Spectrum; % could not be derived as denominators for all data points
are not known
• The projected rapid rise of HIV incidence in the general population is inconsistent with the trends of stabilization in both
incidence and prevalence that can be attested in the last years. This may be however explained by a limitation in defining
groups at risk in EPP: migrants and clients of sex workers could not be defined as separate groups due to lack of
prevalence data, but anecdotal evidence may suggest that they have a role to play in the prevailing heterosexual mode of
transmission.
• Following the export of incidence from EPP2009 into Spectrum, and creating 2 separate datasets with identical input
and different eligibility criteria for ART treatment enrolment (CD4<200 and CD4<350), projections in the 2 different
outputs are not comparable. Expectations were that No of PLWHA would increase, while the number of annual AIDS
deaths will be smaller in the dataset with eligibility criteria for ART enrolment of CD4<350 (since enrolment into treatment
occurs earlier and the survival rate should increase consequentially); however, the reverse outputs were received.
EAD has instructed us not to compare the two datasets, except where need of treatment is concerned. However,
validation of the two datasets is extremely difficult as plausible explanations are difficult to identify.
• The number of projected children living with HIV is smaller than augmented by the routine data currently on hand; while
the reduced MTCT rate is a plausible explanation, the number of new cases being small, the annual decrease in the total
No of children living with HIV occurs at a more rapid rate than the annual number of deaths or the ageing out factor
(children growing above the age 14, and being accounted for in the total PLHIV 15+). The gender distribution in equal
proportions is again inconsistent with routine data.
• The projected number of HIV+ pregnant women is again lower than the targets for 2015 inputed in Spectrum (129 for
CD4<200 and 132 for CD4<350)
The limitations of the estimations presented above may be explained with the fact that for the Republic of Moldova the
input numbers are very small, the inputs in EPP2009 for some of the risk groups have just a few data points in time.
Overall the dataset with CD4<200 has more appropriate estimations for Republic of Moldova, but still there is a need for
clarifications and explanation of outputs, in order to ensure greater reliability of estimations and projections and hence
enhanced use in decision making and strategic planning.
Works Cited
Stover, J. (2009). AIM A Computer Program for Making HIV/AIDS Projections and Examining the Demographic and
Social Impacts of AIDS. USAID | Health Policy Initiative.
UNAIDS Reference group on Estimates, Modelling and Projections. (2009). ESTIMATING NATIONAL ADULT
PREVALENCE OF HIV−1 IN CONCENTRATED EPIDEMICS. Retrieved March 25, 2010, from www.unaids.org:
http://data.unaids.org/pub/Agenda/2009/20090512_epp_concepi_2009_draft_en.pdf
25