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Joint analysis of HIV and AIDS surveillance data in back-calculation

✍ Scribed by Rino Bellocco; Ian C. Marschner


Publisher
John Wiley and Sons
Year
2000
Tongue
English
Weight
145 KB
Volume
19
Category
Article
ISSN
0277-6715

No coin nor oath required. For personal study only.

✦ Synopsis


AIDS surveillance data are the main source of information to perform back-calculation of HIV incidence. We propose a method to incorporate additional information gained by linkage with an HIV surveillance system, containing data on the time of "rst positive HIV test. In this paper we generalize an earlier method that was developed to use HIV testing data available only for AIDS cases. The new method also makes use of cases with an HIV positive test who have not yet developed AIDS, typically a substantial proportion of the HIV-infected population. Furthermore, we use a more realistic model for the HIV testing rate, incorporating dependence on both time since infection and calendar time. The method makes use of an EM algorithm with generalized additive model smoothing, and is applied to data from Veneto, a region of northern Italy. Our results show that HIV incidence in Veneto peaked in the late 1980s, and decreased thereafter. Importantly, the HIV incidence estimates based on joint analysis of HIV and AIDS surveillance data are more e$cient than estimates based on AIDS surveillance data alone. Our estimates also show a decreasing trend in the HIV testing rate over time, which leads to the conclusion that the interval between HIV infection and "rst positive test has lengthened over time. Furthermore, it is found that for infected individuals, the probability of seeking on HIV test is highest soon after infection.


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