pre-amble: the promises and pitfalls of using assays for recent infection to estimate hiv incidence...
Post on 21-Dec-2015
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Pre-amble: The promises and pitfalls of using assays for recent
infection to estimate HIV incidence
Denis Nash, PhD, MPH
Associate Professor
Epidemiology and Biostatistics Program
Hunter College School of Public Health
SED Core, HIV Center for Clinical and Behavioral Studies
HIV statusunknown
A prospective study of HIV incidence
Recruitment
A prospective study of HIV incidence
HIV negative
HIVpositive
HIV testingRecruitment
A prospective study of HIV incidence
6 monthsBaseline
HIVpositive
(excluded)
Prospective follow-up
Enrollment of HIV negatives
Prospective follow-upHIV
negative(study
participants)
HIV testingRecruitmentSeroconverted
Did notseroconvert
6 monthsBaseline
HIVpositive
(excluded)
Did notseroconvert
Prospective follow-up
Seroconverted
Person-timeIncidence
rate=
Calculation of HIV incidence
A prospective study of HIV incidence
Enrollment of HIV negatives
Prospective follow-up
HIV testingRecruitment
A cross-sectional study of HIV incidence (STARHS)
HIV statusunknown
Recruitment
6 monthsBaseline Retrospective follow-up
1. Identification of HIV-positive personsvia conventional HIVtesting
A cross-sectional study of HIV incidence (STARHS)
2. Additional testing ofHIV positives by recentInfection assay
Seroconvertedin last 6 months
Seroconverted>6 months ago
6 monthsBaseline Retrospective follow-up
HIV-negative
Seroconvertedin last 6 months
Seroconverted>6 months ago
Person-time
Incidencerate
=
A cross-sectional study of HIV incidence (STARHS)
Calculation of HIV incidence
Excluded
6 monthsBaseline Retrospective follow-up
Person-time
Incidencerate
=
Seroconverted
>6 months ago
(excluded)
Seroconverted
in last 6 months
HIV-negative
Person-time
Baseline 6 months
Incidencerate =
HIVpositive(exclude
d)
Prospective follow-up
Did notseroconver
tSeroconverte
d
Prospective study STARHS (cross-sectional)
Baseline 6 monthsProspectiv
e follow-up