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American Journal of Epidemiology Vol. 141, No. 2: 166-172
Copyright © 1995 by The Johns Hopkins University School of Hygiene and Public Health

research-article

Estimation of Current Human Immunodeficiency Virus Incidence Rates from a Cross-Sectional Survey Using Early Diagnostic Tests

Ron Brookmeyer1, and Thomas C. Quinn2

1Department of Biostatistics, School of Hygiene and Public Health, The Johns Hopkins University 615 North Wolfe Street, Baltimore, MD 21205
2Division of Infectious Diseases, The Johns Hopkins University School of Medicine Baltimore, MD and the National Institutes of Allergy and Infectious Diseases Bethesda, MD

Department of Biostatistics, School of Hygiene and Public Health, The Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD 21205. (Reprint requests to Dr. Brookmeyer at this address.)

In sharp contrast to the considerable worldwide epidemiologic data available on acquired immunodeficiency syndrome incidence and human immunodeficiency virus (HIV) seroprevalence, there is relatively little information about current levels of HIV incidence rates. The authors suggest a novel approach for estimating current HIV incidence rates based on a single cross-sectional survey and on an epidemiologic model. The approach is based on diagnostic tests for HIV p24 antigen to identify individuals in the preantibody or window period (time between exposure to HIV and appearance of detectable HIV antibodies). Individuals in the preantibody period are likely to have been infected very recently because the duration of the preantibody period is relatively short. The authors report data on the duration of p24 antigenemia prior to HIV serocon version. This duration together with the prevalence of p24 antigenemia obtained from a cross-sectional survey are used in an epidemiologic model to estimate current incidence rates. This approach of estimating incidence rates may be especially useful in developing countries and high-risk populations in which it is difficult to follow cohorts to identify seroconverters, and in the design of vaccine efficacy studies in which current incidence rates are crucial for calculating sample sizes.

acquired immunodeficlency syndrome; cross-sectional studies; epidemiologic methods; HIV seroprevalence statistics


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