Snapshot Estimators of Recent HIV Incidence Rates

The recent HIV incidence rate (or hazard rate for infection) is an important quantity for use in monitoring the HIV/AIDS epidemic, evaluating HIV prevention programs, and allocating HIV prevention resources. Direct measurement of HIV incidence is difficult and time consuming, while estimating HIV incidence via backcalculation (deconvolution) using AIDS incidence data and the (presumed known) HIV incubation time distribution yields little information about recent infection. We propose a method for estimating recent HIV incidence in a population via a single sample at a single point in time. The method relies on understanding the progression of certain markers such as CD4 counts following infection. The actual formulas derived for the point and interval estimates of HIV incidence are simple and easy to use while the sample sizes needed to implement our approach are reasonable. We present two applications of our approach, comparing our results to those obtained from more conventional methods where possible.

[1]  Mitchell H. Gail,et al.  AIDS Epidemiology: A Quantitative Approach , 1994 .

[2]  R. Valdiserri,et al.  Community planning: A national strategy to improve HIV prevention programs , 1995, Journal of community health.

[3]  Mitchell H. Gail,et al.  A Method for Obtaining Short-Term Projections and Lower Bounds on the Size of the AIDS Epidemic , 1988 .

[4]  K Y Liang,et al.  Longitudinal data analysis for discrete and continuous outcomes. , 1986, Biometrics.

[5]  J. Levy,et al.  The San Francisco Men's Health Study: III. Reduction in human immunodeficiency virus transmission among homosexual/bisexual men, 1982-86. , 1987, American journal of public health.

[6]  I. Longini,et al.  Estimation of incidence of HIV infection using cross-sectional marker surveys. , 1994, Biometrics.

[7]  D. Vlahov,et al.  Temporal trends of incident human immunodeficiency virus infection in a cohort of injecting drug users in Baltimore, Md. , 1995, Archives of internal medicine.

[8]  J. Little A Proof for the Queuing Formula: L = λW , 1961 .

[9]  E. H. Kaplan Economic analysis of needle exchange. , 1995, AIDS.

[10]  R Brookmeyer,et al.  Reconstruction and future trends of the AIDS epidemic in the United States. , 1991, Science.

[11]  D. Vlahov,et al.  Maturity of human immunodeficiency virus infection and incubation period of acquired immunodeficiency syndrome in injecting drug users. , 1994, Annals of epidemiology.

[12]  R Brookmeyer,et al.  Estimation of current human immunodeficiency virus incidence rates from a cross-sectional survey using early diagnostic tests. , 1995, American journal of epidemiology.

[13]  F. DiNola [AIDS in the world]. , 1991, Sykepleien. Fag.

[14]  N. Breslow,et al.  Statistical methods in cancer research. Volume II--The design and analysis of cohort studies. , 1987, IARC scientific publications.

[15]  Tomos Philipson,et al.  Modeling the AIDS Epidemic: Planning, Policy, and Prediction , 1994 .

[16]  D R Holtgrave,et al.  Threshold Analysis and Programs for Prevention of HIV Infection , 1995, Medical decision making : an international journal of the Society for Medical Decision Making.

[17]  Niels G. Becker MODELING THE AIDS EPIDEMIC: PLANNING, POLICY AND PREDICTION. , 1996 .

[18]  R. Brookmeyer,et al.  The AIDS epidemic in India: a new method for estimating current human immunodeficiency virus (HIV) incidence rates. , 1995, American journal of epidemiology.

[19]  I M Longini,et al.  The dynamics of CD4+ T-lymphocyte decline in HIV-infected individuals: a Markov modeling approach. , 1991, Journal of acquired immune deficiency syndromes.

[20]  Stephen E. Fienberg,et al.  Discrete Multivariate Analysis: Theory and Practice , 1976 .

[21]  P. Bacchetti Estimating the Incubation Period of AIDS by Comparing Population Infection and Diagnosis Patterns , 1990 .

[22]  Norman E. Breslow,et al.  The design and analysis of cohort studies , 1987 .

[23]  J. Auerbach,et al.  AIDS and behavior : an integrated approach , 1994 .

[24]  Shang Zhi,et al.  A proof of the queueing formula: L=λW , 2001 .

[25]  Estimates of HIV prevalence and projected AIDS cases: summary of a workshop, October 31-November 1, 1989. , 1990, MMWR. Morbidity and mortality weekly report.

[26]  Edward H. Kaplan,et al.  Probability Models of Needle Exchange , 1995, Oper. Res..