Yale University

Estimating HIV incidence in the United States from HIV/AIDS surveillance data and biomarker HIV test results.

TitleEstimating HIV incidence in the United States from HIV/AIDS surveillance data and biomarker HIV test results.
Publication TypeJournal Article
Year of Publication2008
AuthorsKaron, John M., Ruiguang Song, Ron Brookmeyer, Edward H. Kaplan, and Irene H. Hall
JournalStatistics in medicine
Volume27
Issue23
Pagination4617-33
Date Published2008 Oct 15
ISSN0277-6715
KeywordsAlgorithms, Biological Markers, Cohort Studies, Early Diagnosis, Forecasting, HIV Infections, Humans, Population Surveillance, United States
AbstractThe development of an human immunodeficiency virus (HIV) test that detects recent infection has enabled the U.S. Centers for Disease Control and Prevention (CDC) to estimate annual HIV incidence (number of new infections per year, not per person at risk) in the United States from data on new HIV and acquired immunodeficiency syndrome (AIDS) diagnoses reported to HIV/AIDS surveillance. We developed statistical procedures to estimate the probability that an infected person will be detected as recently infected, accounting for individuals choosing whether and how frequently to seek HIV testing, variation of testing frequency, the reporting of test results only for infected persons, and infected persons who never had an HIV-negative test. The incidence estimate is the number of persons detected as recently infected divided by the estimated probability of detection. We used simulation to show that, under the assumptions we make, our procedures have acceptable bias and correct confidence interval coverage. Because data on the biomarker for recent infection or on testing history were missing for many persons, we used multiple imputation to apply our models to surveillance data. CDC has used these procedures to estimate HIV incidence in the United States.
Alternate JournalStat Med

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