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

John M. Karon, Ruiguang Song, Ron Brookmeyer, Edward H. Kaplan, H. Irene Hall

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)4617-4633
Number of pages17
JournalStatistics in Medicine
Volume27
Issue number23
DOIs
StatePublished - Oct 15 2008

Fingerprint

Biomarkers
Surveillance
Virus
Incidence
Acquired Immunodeficiency Syndrome
HIV
Person
Infection
Centers for Disease Control and Prevention (U.S.)
Estimate
Testing
Probability of Detection
Multiple Imputation
Human
Annual
Confidence interval
Coverage
History
Confidence Intervals
Simulation

Keywords

  • HIV
  • Incidence
  • Surveillance

ASJC Scopus subject areas

  • Epidemiology
  • Statistics and Probability

Cite this

Estimating HIV incidence in the United States from HIV/AIDS surveillance data and biomarker HIV test results. / Karon, John M.; Song, Ruiguang; Brookmeyer, Ron; Kaplan, Edward H.; Hall, H. Irene.

In: Statistics in Medicine, Vol. 27, No. 23, 15.10.2008, p. 4617-4633.

Research output: Contribution to journalArticle

Karon, John M. ; Song, Ruiguang ; Brookmeyer, Ron ; Kaplan, Edward H. ; Hall, H. Irene. / Estimating HIV incidence in the United States from HIV/AIDS surveillance data and biomarker HIV test results. In: Statistics in Medicine. 2008 ; Vol. 27, No. 23. pp. 4617-4633.
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