A comparison of South African national HIV incidence estimates: A critical appraisal of different methods

 

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dc.contributor.author Rehle, Thomas en_ZA
dc.contributor.author Johnson, Leigh en_ZA
dc.contributor.author Hallett, Timothy en_ZA
dc.contributor.author Mahy, Mary en_ZA
dc.contributor.author Kim, Andrea en_ZA
dc.contributor.author Odido, Helen en_ZA
dc.contributor.author Onoya, Dorina en_ZA
dc.contributor.author Jooste, Sean en_ZA
dc.contributor.author Shisana, Olive en_ZA
dc.contributor.author Puren, Adrian en_ZA
dc.date.accessioned 2015-11-16T04:08:05Z
dc.date.available 2015-11-16T04:08:05Z
dc.date.issued 2015 en_ZA
dc.identifier.citation Rehle, T., Johnson, L., Hallett, T., Mahy, M., Kim, A., Odido, H., ... & Stover, J. (2015). A comparison of South African national HIV incidence estimates: A critical appraisal of different methods. PloS one, 10(7), e0133255. doi:10.1371/journal.pone.0133255 en_ZA
dc.identifier.uri http://hdl.handle.net/11427/14988
dc.identifier.uri http://dx.doi.org/10.1371/journal.pone.0133255
dc.description.abstract BACKGROUND: 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. Methods and FINDINGS: 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. CONCLUSIONS: 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. en_ZA
dc.language.iso eng en_ZA
dc.publisher Public Library of Science en_ZA
dc.rights This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. en_ZA
dc.rights.uri http://creativecommons.org/licenses/by/4.0 en_ZA
dc.source PLoS One en_ZA
dc.source.uri http://journals.plos.org/plosone en_ZA
dc.subject.other HIV epidemiology en_ZA
dc.subject.other Antiretroviral therapy en_ZA
dc.subject.other Mathematical models en_ZA
dc.title A comparison of South African national HIV incidence estimates: A critical appraisal of different methods en_ZA
dc.type Journal Article en_ZA
dc.rights.holder © 2015 Rehle et al en_ZA
uct.type.publication Research en_ZA
uct.type.resource Article en_ZA
dc.publisher.institution University of Cape Town
dc.publisher.faculty Faculty of Health Sciences en_ZA
dc.publisher.department Institute of Infectious Disease and Molecular Medicine en_ZA
uct.type.filetype Text
uct.type.filetype Image


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This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Except where otherwise noted, this item's license is described as This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.