American Journal of Epidemiology Vol. 147, No. 9: 834-839
Copyright © 1998 by The Johns Hopkins University School of Hygiene and Public Health
other |
Direct and Indirect Estimates of HIV-1 Incidence in a High-Prevalence Population
1 The Viral Epidemiology Branch, Division of Cancer Etiology, National Cancer Institute, National Institutes of Health Bethesda, MD
2 The Caribbean Epidemiology Centre, Port of Spain Trinidad
3 Research Triangle Institute, Epidemiology and Medical Studies Program Washington, DC
4 The Ministry of Health, Government of Trinidad and Tobago Trinidad
5 The University of the West Indies, Department of Medicine, Port of Spain Trinidad
6 Duke University Center for AIDS Research Raleigh-Durham, NC
7 Department of Biostatistics, The Johns Hopkins University Baltimore, MD
8 Institute of Human Virology, University of Maryland Baltimore, MD
Reprint requests to Dr. Farley R. Cleghorn, Division of Epidemiology and Prevention, Institute of Human Virology, University of Maryland, Suite N445, 725 W. Lombard Street, Baltimore, MD 21201.
While the worldwide AIDS epidemic continues to expand, directly measured incidence data are difficult to obtain. Methods to reliably estimate human immunodeficiency virus type 1 (HIV-1) incidence from more easily available data are particularly relevant in those parts of the world where prevalence is rising in heterosexually exposed populations. The authors set out to estimate HIV-1 incidence in a population of heterosexual sexually transmitted disease clinic attendees in Trinidad who had a known high prevalence of HIV-1 subtype B. Over the period 1987–1995, HIV-1 incidence estimates from serial cross-sectional studies of HIV-1 prevalence, passive follow up of clinic recidivists, modeling of early markers of HIV-1 infection (p24 antigen screening), and a cohort study of seronegative genital ulcer disease cases were compared. Measuring incidence density in the genital ulcer disease cases directly gave the highest estimate, 6.9% per annum. Screening for the detection of early HIV-1 markers yielded an incidence of 5.0% per annum, while estimating incidence from serial cross-sectional prevalence data and clinic recidivists gave estimates of 3.5% and 4.5% per annum, respectively. These results were found to be internally consistent. Indirect estimates of incidence based on prevalence data can give accurate surrogates of true incidence. Within limitations, even crude measures of incidence are robust enough for health planning and evaluation purposes. For planning vaccine efficacy trials, consistent conservative estimates may be used to evaluate populations before targeting them for cohort studies. Am J Epidemiol 1998; 147:834–9.
cohort studies; cross-sectional studies; genital diseases; male; HIV-1; incidence; prevaience; sexually transmitted disease; vaccines
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  Y. Xiao, Y. Jiang, J. Feng, W. Xu, M. Wang, E. Funkhouser, S. H. Vermund, and Y. Jia Seroincidence of Recent Human Immunodeficiency Virus Type 1 Infections in China Clin. Vaccine Immunol., October 1, 2007; 14(10): 1384 - 1386. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Halcon, R. W. Blum, T. Beuhring, E. Pate, S. Campbell-Forrester, and A. Venema Adolescent Health in the Caribbean: A Regional Portrait Am J Public Health, November 1, 2003; 93(11): 1851 - 1857. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. R. Cleghorn, N. Jack, J. K. Carr, J. Edwards, B. Mahabir, A. Sill, C. B. McDanal, S. M. Connolly, D. Goodman, R. Q. Bennetts, et al. A distinctive clade B HIV type 1 is heterosexually transmitted in Trinidad and Tobago PNAS, September 12, 2000; 97(19): 10532 - 10537. [Abstract] [Full Text] [PDF]
|
|