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A Comparison of South African National HIV Incidence Estimates: A Critical Appraisal of Different Methods
- Source :
- PLoS One, PLoS ONE, PLoS ONE, Vol 10, Iss 7, p e0133255 (2015)
- Publication Year :
- 2015
- Publisher :
- Public Library of Science (PLoS), 2015.
-
Abstract
- Background The interpretation of HIV prevalence trends is increasingly difficult as antiretroviral treatment programs expand. Reliable HIV incidence estimates are critical to monitoring transmission trends and guiding an effective national response to the epidemic. Methods and Findings We used a range of methods to estimate HIV incidence in South Africa: (i) an incidence testing algorithm applying the Limiting-Antigen Avidity Assay (LAg-Avidity EIA) in combination with antiretroviral drug and HIV viral load testing; (ii) a modelling technique based on the synthetic cohort principle; and (iii) two dynamic mathematical models, the EPP/Spectrum model package and the Thembisa model. Overall, the different incidence estimation methods were in broad agreement on HIV incidence estimates among persons aged 15-49 years in 2012. The assay-based method produced slightly higher estimates of incidence, 1.72% (95% CI 1.38 – 2.06), compared with the mathematical models, 1.47% (95% CI 1.23 – 1.72) in Thembisa and 1.52% (95% CI 1.43 – 1.62) in EPP/Spectrum, and slightly lower estimates of incidence compared to the synthetic cohort, 1.9% (95% CI 0.8 – 3.1) over the period from 2008 to 2012. Among youth aged 15-24 years, a declining trend in HIV incidence was estimated by all three mathematical estimation methods. Conclusions The multi-method comparison showed similar levels and trends in HIV incidence and validated the estimates provided by the assay-based incidence testing algorithm. Our results confirm that South Africa is the country with the largest number of new HIV infections in the world, with about 1 000 new infections occurring each day among adults aged 15-49 years in 2012.
- Subjects :
- Male
Gerontology
Human immunodeficiency virus (HIV)
lcsh:Medicine
HIV Infections
medicine.disease_cause
South Africa
0302 clinical medicine
INFECTION
Medicine
030212 general & internal medicine
Young adult
lcsh:Science
Mathematical models
0303 health sciences
Multidisciplinary
Transmission (medicine)
Incidence
Incidence (epidemiology)
Hiv incidence
Middle Aged
Antiretroviral therapy
3. Good health
Multidisciplinary Sciences
ANTIRETROVIRAL TREATMENT
INSIGHTS
HIV epidemiology
Science & Technology - Other Topics
Female
Viral load
Algorithms
Research Article
Adult
Adolescent
General Science & Technology
PROJECTION PACKAGE
Developing country
Young Adult
03 medical and health sciences
MD Multidisciplinary
Humans
Science & Technology
030306 microbiology
business.industry
lcsh:R
Models, Theoretical
UNAIDS ESTIMATION
TRENDS
MODEL
Critical appraisal
lcsh:Q
business
Demography
Subjects
Details
- ISSN :
- 19326203
- Volume :
- 10
- Database :
- OpenAIRE
- Journal :
- PLOS ONE
- Accession number :
- edsair.doi.dedup.....0bdd3824321a4267d3abd2ea7a299ee5