HIV Estimation and Projection in Sri Lanka (2019-2025); Application of AIDS Epidemic Model and Spectrum

Introduction: Since the beginning of the HIV epidemic in the late 1980s, Sri Lanka has been classified as a country with low level HIV epidemic. Even among key populations, HIV prevalence has not exceeded beyond 5%. HIV estimation and projection in Sri Lanka are more important than ever when the country is trying to reach ending AIDS epidemic targets by 2025.

Objective: This study aims to generate HIV estimates for Sri Lanka and identify the pattern of the AIDS epidemic and develop future directions.

Method: AIDS Epidemic Model (AEM) and Spectrum were used as tools to generate the estimates by Technical Working Group (TWG) which was represented by the relevant government, nongovernment, UN and technical partners. Sub-national estimates were not attempted during the current AIDS Epidemic Modelling due to the lack of region-specific data as well as expected low numbers in a sub-national estimate in Sri Lanka.

Results: Results of national estimates indicate that there are 3,600 people living with HIV (PLHIV) in Sri Lanka in 2019. Of this estimate, 3,550 are adults who are 15 years and older, and the male to female ratio was 2.93. The trend of PLHIV is relatively stable in the past five years implying the state of balance between new infections and AIDS related deaths. Total new HIV infections were estimated at 140 in 2019 with 137 new HIV infections among adults 15 years and older. Although the epidemic is declining in terms of numbers, new HIV infections among men who have sex with men (MSM) as share of total new HIV infections is growing. In 2019, 169 AIDS-related deaths are estimated among adults living with HIV.

Conclusions: AIDS epidemic in Sri Lanka is seems to be under control but not yet over. The National Strategic Plan scenario showed that ending AIDS is achievable. However, this needs scale up of current HIV prevention efforts based on the informed policy and decision making.