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

The 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...

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Bibliographic Details
Published in:Statistics in medicine 2008-10, Vol.27 (23), p.4617-4633
Main Authors: Karon, John M., Song, Ruiguang, Brookmeyer, Ron, Kaplan, Edward H., Hall, H. Irene
Format: Article
Language:English
Subjects:
Acquired immune deficiency syndrome
AIDS
Algorithms
Biomarkers
Cohort Studies
Disease control
Disease prevention
Early Diagnosis
Epidemiology
Forecasting
HIV
HIV Infections - diagnosis
HIV Infections - epidemiology
Human immunodeficiency virus
Humans
incidence
Medical tests
Population Surveillance - methods
surveillance
United States - epidemiology
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Summary:The 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. Copyright © 2008 John Wiley & Sons, Ltd.
ISSN:0277-6715
1097-0258
DOI:10.1002/sim.3144