A Comparison of South African National HIV Incidence Estimates: A Critical Appraisal of Different Methods.
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.We used a range of methods to estimate HIV inc...
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| Format: | Article |
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Public Library of Science (PLoS)
2015-01-01
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| Online Access: | http://europepmc.org/articles/PMC4521952?pdf=render |
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| author | Thomas Rehle Leigh Johnson Timothy Hallett Mary Mahy Andrea Kim Helen Odido Dorina Onoya Sean Jooste Olive Shisana Adrian Puren Bharat Parekh John Stover |
| author_facet | Thomas Rehle Leigh Johnson Timothy Hallett Mary Mahy Andrea Kim Helen Odido Dorina Onoya Sean Jooste Olive Shisana Adrian Puren Bharat Parekh John Stover |
| author_sort | Thomas Rehle |
| collection | DOAJ |
| description | 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.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.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. |
| first_indexed | 2024-12-11T07:29:12Z |
| format | Article |
| id | doaj.art-a09e0e5800ea4a44b0fbd1c1088a98e1 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-11T07:29:12Z |
| publishDate | 2015-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-a09e0e5800ea4a44b0fbd1c1088a98e12022-12-22T01:15:53ZengPublic Library of Science (PLoS)PLoS ONE1932-62032015-01-01107e013325510.1371/journal.pone.0133255A Comparison of South African National HIV Incidence Estimates: A Critical Appraisal of Different Methods.Thomas RehleLeigh JohnsonTimothy HallettMary MahyAndrea KimHelen OdidoDorina OnoyaSean JoosteOlive ShisanaAdrian PurenBharat ParekhJohn StoverThe 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.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.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.http://europepmc.org/articles/PMC4521952?pdf=render |
| spellingShingle | Thomas Rehle Leigh Johnson Timothy Hallett Mary Mahy Andrea Kim Helen Odido Dorina Onoya Sean Jooste Olive Shisana Adrian Puren Bharat Parekh John Stover A Comparison of South African National HIV Incidence Estimates: A Critical Appraisal of Different Methods. PLoS ONE |
| title | A Comparison of South African National HIV Incidence Estimates: A Critical Appraisal of Different Methods. |
| title_full | A Comparison of South African National HIV Incidence Estimates: A Critical Appraisal of Different Methods. |
| title_fullStr | A Comparison of South African National HIV Incidence Estimates: A Critical Appraisal of Different Methods. |
| title_full_unstemmed | A Comparison of South African National HIV Incidence Estimates: A Critical Appraisal of Different Methods. |
| title_short | A Comparison of South African National HIV Incidence Estimates: A Critical Appraisal of Different Methods. |
| title_sort | comparison of south african national hiv incidence estimates a critical appraisal of different methods |
| url | http://europepmc.org/articles/PMC4521952?pdf=render |
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