TY - JOUR
T1 - Estimating sizes of key populations at the national level
T2 - Considerations for study design and analysis
AU - Edwards, Jessie K.
AU - Hileman, Sarah
AU - Donastorg, Yeycy
AU - Zadrozny, Sabrina
AU - Baral, Stefan
AU - Hargreaves, James R.
AU - Fearon, Elizabeth
AU - Zhao, Jinkou
AU - Datta, Abhirup
AU - Weir, Sharon S.
N1 - Publisher Copyright:
Copyright © 2018 The Author(s). Published by Wolters Kluwer Health, Inc.
PY - 2018
Y1 - 2018
N2 - Background: National estimates of the sizes of key populations, including female sex workers, men who have sex with men, and transgender women are critical to inform national and international responses to the HIV pandemic. However, epidemiologic studies typically provide size estimates for only limited high priority geographic areas. This article illustrates a two-stage approach to obtain a national key population size estimate in the Dominican Republic using available estimates and publicly available contextual information. Methods: Available estimates of key population size in priority areas were augmented with targeted additional data collection in other areas. To combine information from data collected at each stage, we used statistical methods for handling missing data, including inverse probability weights, multiple imputation, and augmented inverse probability weights. Results: Using the augmented inverse probability weighting approach, which provides some protection against parametric model misspecification, we estimated that 3.7% (95% CI = 2.9, 4.7) of the total population of women in the Dominican Republic between the ages of 15 and 49 years were engaged in sex work, 1.2% (95% CI = 1.1, 1.3) of men aged 15-49 had sex with other men, and 0.19% (95% CI = 0.17, 0.21) of people assigned the male sex at birth were transgender. Conclusions: Viewing the size estimation of key populations as a missing data problem provides a framework for articulating and evaluating the assumptions necessary to obtain a national size estimate. In addition, this paradigm allows use of methods for missing data familiar to epidemiologists.
AB - Background: National estimates of the sizes of key populations, including female sex workers, men who have sex with men, and transgender women are critical to inform national and international responses to the HIV pandemic. However, epidemiologic studies typically provide size estimates for only limited high priority geographic areas. This article illustrates a two-stage approach to obtain a national key population size estimate in the Dominican Republic using available estimates and publicly available contextual information. Methods: Available estimates of key population size in priority areas were augmented with targeted additional data collection in other areas. To combine information from data collected at each stage, we used statistical methods for handling missing data, including inverse probability weights, multiple imputation, and augmented inverse probability weights. Results: Using the augmented inverse probability weighting approach, which provides some protection against parametric model misspecification, we estimated that 3.7% (95% CI = 2.9, 4.7) of the total population of women in the Dominican Republic between the ages of 15 and 49 years were engaged in sex work, 1.2% (95% CI = 1.1, 1.3) of men aged 15-49 had sex with other men, and 0.19% (95% CI = 0.17, 0.21) of people assigned the male sex at birth were transgender. Conclusions: Viewing the size estimation of key populations as a missing data problem provides a framework for articulating and evaluating the assumptions necessary to obtain a national size estimate. In addition, this paradigm allows use of methods for missing data familiar to epidemiologists.
KW - Epidemiologic methods
KW - HIV
KW - Sex workers
KW - Sexual and gender minorities
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U2 - 10.1097/EDE.0000000000000906
DO - 10.1097/EDE.0000000000000906
M3 - Article
C2 - 30119057
AN - SCOPUS:85057523318
SN - 1044-3983
VL - 29
SP - 795
EP - 803
JO - Epidemiology
JF - Epidemiology
IS - 6
ER -