Estimating HIV incidence in populations using tests for recent infection: issues, challenges and the way forward

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dc.date.accessioned 2010-11-10 en
dc.date.accessioned 2023-07-23T19:05:20Z
dc.date.available 2023-07-23T19:05:20Z
dc.date.issued 2015-08-25 en
dc.identifier.uri http://hdl.handle.net/20.500.11910/4026
dc.description.abstract HIV incidence is the rate of new infections in a population over time. HIV incidence is a critical indicator needed to assess the status and trends of the HIV epidemic in populations and guide and assess the impact of prevention interventions. Methods: Several methods exist for estimating population-level HIV incidence: direct observation of HIV incidence through longitudinal follow-up of persons at risk for new HIV infection, indirect measurement of HIV incidence using data on HIV prevalence and mortality in a population, and direct measurement of HIV incidence through use of tests for recent infection (TRIs) that can differentiate "recent" from "non-recent" infections based on biomarkers in cross-sectional specimens. Given the limitations in measuring directly observed incidence and the assumptions needed for indirect measurements of incidence, there is an increasing demand for TRIs for HIV incidence surveillance and program monitoring and evaluation purposes. Results: Over ten years since the introduction of the first TRI, a number of low-, middle-, and high-income countries have integrated this method into their HIV surveillance systems to monitor HIV incidence in the population. However, the accuracy of these assays for measuring HIV incidence has been unsatisfactory to date, mainly due to misclassification of chronic infections as recent infection on the assay. To improve the accuracy of TRIs for measuring incidence, countries are recommended to apply case-based adjustments, formula-based adjustments using local correction factors, or laboratory-based adjustment to minimize error related to assay misclassification. Multiple tests may be used in a recent infection testing algorithm (RITA) to obtain more accurate HIV incidence estimates. Conclusion: There continues to be a high demand for improved TRIs and RITAs to monitor HIV incidence, determine prevention priorities, and assess impact of interventions. Current TRIs have noted limitations, but with appropriate adjustments, interpreted in parallel with other epidemiologic data, may still provide useful information on new infections in a population. New TRIs and RITAs with improved accuracy and performance are needed and development of these tools should be supported. en
dc.format.medium Print en
dc.subject HIV/AIDS en
dc.subject HIV TESTING AND COUNSELLING (HTC) en
dc.title Estimating HIV incidence in populations using tests for recent infection: issues, challenges and the way forward en
dc.type Journal Article en
dc.description.version Y en
dc.ProjectNumber N/A en
dc.Volume 2(1) en
dc.BudgetYear 2010/11 en
dc.ResearchGroup HIV/AIDS, STIs and TB en
dc.SourceTitle Journal of HIV/AIDS Surveillance & Epidemiology en
dc.ArchiveNumber 6589 en
dc.PageNumber Online en
dc.outputnumber 5239 en
dc.bibliographictitle Mastro, T.D., Kim, A.A., Hallett, T, Rehle, T., Welte, A., Laeyendecker, O., Oluoch, T. & Garcia-Calleja, J.M. (2010) Estimating HIV incidence in populations using tests for recent infection: issues, challenges and the way forward. Journal of HIV/AIDS Surveillance & Epidemiology. 2(1):Online. http://hdl.handle.net/20.500.11910/4026 http://hdl.handle.net/20.500.11910/4026 en
dc.publicationyear 2010 en
dc.contributor.author1 Mastro, T.D. en
dc.contributor.author2 Kim, A.A. en
dc.contributor.author3 Hallett, T en
dc.contributor.author4 Rehle, T. en
dc.contributor.author5 Welte, A. en
dc.contributor.author6 Laeyendecker, O. en
dc.contributor.author7 Oluoch, T. en
dc.contributor.author8 Garcia-Calleja, J.M. en


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