Insights into the rise in HIV infections, 2001 to 2008: a Bayesian synthesis of prevalence evidence
- 27 November 2010
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in AIDS
- Vol. 24 (18), 2849-2858
- https://doi.org/10.1097/qad.0b013e32834021ed
Abstract
Objective: To estimate trends in prevalence of HIV infection, undiagnosed and total, among adults aged 15-44 years in England and Wales since 2001. Design: Multiple surveillance systems and survey data are available to inform different aspects of the HIV epidemic in England and Wales. To coherently and consistently combine this information to estimate trends in HIV prevalence, we apply a multi-parameter evidence synthesis in a Bayesian statistical framework. Methods: The study population is stratified by exposure group and region of residence. We synthesize data from behavioural and community surveys, unlinked anonymous seroprevalence surveys, and an annual survey of individuals with diagnosed HIV infection. Prevalence estimates are given with 95% credible intervals. Results: The estimated number of prevalent HIV infections in 15-44-year-olds has increased from 32 400 (29 600-35 900) in 2001 to 54 500 (50 500-59 100) in 2008, corresponding to an estimated prevalence of 1.5 per 1000 (1.4-1.7) rising to 2.4 per 1000 (2.3-2.6) in 2008. A rise in prevalence of diagnosed infection contributes substantially to the increase. There is no evidence of a statistically significant decrease in the prevalence of undiagnosed infection. The proportion of infections that are diagnosed has therefore also increased. Conclusion: Although the increase in the proportion of infections that are diagnosed is encouraging, the rise in HIV prevalence and lack of evidence of a decrease in prevalence of undiagnosed infection suggest that diagnosis rates are not high enough to reduce the pool of individuals unaware of their infection and that new infections must be occurring. (C) 2010 Wolters Kluwer Health vertical bar Lippincott Williams & WilkinsKeywords
This publication has 17 references indexed in Scilit:
- Conflicting Evidence in a Bayesian Synthesis of Surveillance Data to Estimate Human Immunodeficiency Virus PrevalenceJournal of the Royal Statistical Society Series A: Statistics in Society, 2008
- Progress and challenges in modelling country-level HIV/AIDS epidemics: the UNAIDS Estimation and Projection Package 2007Sexually Transmitted Infections, 2008
- Estimates of Human Immunodeficiency Virus Prevalence and Proportion Diagnosed Based on Bayesian Multiparameter Synthesis of Surveillance DataJournal of the Royal Statistical Society Series A: Statistics in Society, 2008
- Estimating adult HIV prevalence in the UK in 2003: the direct method of estimationSexually Transmitted Infections, 2006
- The 2005 Workbook: an improved tool for estimating HIV prevalence in countries with low level and concentrated epidemicsSexually Transmitted Infections, 2006
- Multiparameter Evidence Synthesis in Epidemiology and Medical Decision-Making: Current ApproachesJournal of the Royal Statistical Society Series A: Statistics in Society, 2005
- The UNAIDS Estimation and Projection Package: a software package to estimate and project national HIV epidemicsSexually Transmitted Infections, 2004
- Sexual behaviour in Britain: partnerships, practices, and HIV risk behavioursThe Lancet, 2001
- Direct estimates of prevalent HIV infection in adults in England and Wales for 1991 and 1993: an improved method.Sexually Transmitted Infections, 1997
- An Estimate of the Prevalence of Human Immunodeficiency Virus Infection in England and Wales by using a Direct MethodJournal of the Royal Statistical Society Series A: Statistics in Society, 1994