Objective

To estimate HIV incidence in the general population in countries where there have been two recent household-based HIV prevalence surveys (the Dominican Republic, Mali, Niger, Tanzania, and Zambia).

Methods

We applied a validated method to estimate HIV incidence using HIV prevalence measurement in two surveys.

Results

We estimate incidence among men and women aged 15–44 years to be: 0.5/1000 person-years at risk in the Dominican Republic 2002–2007, 1.1/1000 in Mali 2001–2006, 0.6/1000 in Niger 2002–2006, 3.4/1000 in Tanzania 2004–2008, and 11.2/1000 in Zambia 2002–2007. The groups most at risk in these epidemics are typically 15–24-year-old women and 25–39-year-old men. Incidence appears to have declined in recent years in all countries, but only significantly among men in the Dominican Republic and Tanzania and women in Zambia.

Conclusion

Using prevalence measurements to estimate incidence reveals the current level and age distribution of new infections and the trajectory of the HIV epidemic. This information is more useful than prevalence data alone and should be used to help determine priorities for interventions.