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In the welter of official statistics, many can naïvely assume that numbers are based on actual counts. However, because of the effort required to collect and collate often rare or hidden events in difficult circumstances this is often not the case and estimates are required. In the case of HIV, infections are often asymptomatic, symptoms often untreated and people living with HIV often undiagnosed and unreported. Thus, estimates of the numbers of infections and cases of disease have to be built from partial data the representativeness of which has to be considered. Over the course of the HIV pandemic a continuous process of updating and improving the quality of data, our understanding of that data and the tools used to analyse the data has been undertaken, led by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and with input from many scientists and technical experts. This effort should increase our confidence in the estimates of numbers of HIV infections and AIDS deaths, which are generated in partnership with national epidemiologists. Along the way the methods developed have been published in the peer review literature to allow critical scrutiny and to share our improving understanding of HIV epidemiology. We believe that the continued reassessment of methods and the transparency of their use have been important in establishing the validity of HIV estimates and facilitating their use in advocacy.
HIV estimates are used to understand the burden of disease and death caused by the virus, to understand trends in incidence and the impact of interventions. The distribution of infections and numbers of people needing treatment should act as a guide to the global, national and local efforts to prevent and treat infections. HIV-associated mortality should show us …