High Incidence of HIV-1 in South Africa Using a Standardized Algorithm for Recent HIV Seroconversion

Gouws, Eleanor; Williams, Brian Glyn; Sheppard, Haynes W.; Enge, Barryett; Karim, Salim Safurdeen. Abdool

doi:10.1097/00042560-200204150-00015

Cited by 8 publications

(8 citation statements)

References 14 publications

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“…Indeed, close to half of all HIV infections in SSA are among those younger than 25 years of age, and females acquire HIV at an earlier age group than males. [15][16][17] These considerations suggest that it is unlikely that the variability in the age distribution of HIV incidence rate will noticeably affect our analysis.…”

Section: Discussionmentioning

confidence: 99%

External infections contribute minimally to HIV incidence among HIV sero-discordant couples in sub-Saharan Africa

Chemaitelly

Abu‐Raddad

2012

Sex Transm Infect

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ObjectiveRecent randomised clinical trials among stable HIV sero-discordant couples (SDCs) in sub-Saharan Africa (SSA) have reported that about 20–30% of new HIV infections are acquired from external sexual partners, rather than transmitted from the infected to the uninfected partner within the couple. The aim of this study is to examine whether, and to what extent, these findings are generalisable to SDCs in the wider population in SSA.MethodsA mathematical model was constructed to calculate the fraction of new HIV-1 infections among SDCs that are due to sources external to the couple. The model was parameterised using empirical and population-based data for 20 countries in SSA. Uncertainty and sensitivity analyses were also conducted.ResultsThe contribution of external infections among SDCs was generally modest, but it varied widely across SSA. In low HIV prevalence countries (≤3.0%), it ranged from 0.6–2.9%. In intermediate prevalence countries (3.0–18.0%), it ranged from 4.9–11.7%. In Swaziland and Lesotho, the world's most-intense epidemics, sizable levels of 27.9% and 27.3% were found, respectively.ConclusionsIn most countries in SSA, nearly all HIV acquisitions by the uninfected partners in SDCs appear to be due to transmissions from the HIV infected partners in the SDCs. The contribution of externally acquired infections varies with HIV population prevalence, but rarely exceeds 10% in the majority of countries. Only in hyperendemic HIV epidemics the contribution of external infections is substantial and may reach the levels reported in recent randomised clinical trials involving SDCs.

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Section: Discussionmentioning

confidence: 99%

External infections contribute minimally to HIV incidence among HIV sero-discordant couples in sub-Saharan Africa

Chemaitelly

Abu‐Raddad

2012

Sex Transm Infect

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“…However, such incidence studies are technically demanding, expensive and subject to bias. Recently, a new laboratory method known as Serological Testing Algorithm for Recent HIV Seroconversion has been developed which detects recent HIV infection by testing a single HIV+ specimen collected from cross‐sectional surveys [1–5]. Another advent is the development of the BED HIV‐1 incidence assay [6–9].…”

Section: Introductionmentioning

confidence: 99%

Temporal trends in the incidence of HIV infection in antenatal clinic attendees in Addis Ababa, Ethiopia, 1995–2003

Wolday

Meles

Hailu

et al. 2007

Journal of Internal Medicine

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Background. The HIV incidence data are relevant in depicting the current dynamics and trend of the epidemic. Using a new laboratory method for HIV‐1 incidence, we aimed at estimating a 10‐year trend in HIV‐1 incidence in Addis Ababa, Ethiopia. Methods. We determined the temporal trends in HIV incidence based on a total of 7744 serum specimens from pregnant women who attended antenatal clinics in Addis Ababa between 1995 and 2003. HIV incidence was determined by IgG‐capture HIV‐1 BED incidence enzyme immunoassay following a validation using a well‐characterized panel of serial serum specimens from subtype C‐infected seroconverters. Findings. Of the 1350 HIV+ specimens tested as part of the annual sentinel survey between 1995 and 2003, a total of 1332 (98.7%) were tested by BED HIV‐1 incidence assay. The incidence rate of HIV‐1 infection declined significantly from 7.7% (95% CI, 3.9–11.5%) in 1995 to 2.0% (95% CI, 0.7–3.3%) in 2003. Although there was a trend, amongst the age group of 15–29 years, in age‐specific decline in incidence, it was not statistically significant. No change in HIV incidence rate was observed for the group aged above 30 years. Interpretation. A corresponding decline in the incidence of HIV infection was observed with the decline in the prevalence of HIV infection between 1995 and 2003 in Addis Ababa City. Whether the declines were because of changes in sexual behaviours or other reasons needs to be explored. The BED HIV‐1 incidence assay provides a valuable tool in obtaining information on recent HIV‐1 infection.

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“…7 It has been applied in numerous other settings among different populations. [8][9][10][11][12][13][14][15][16][17][18] Statistical methods have now been developed to estimate new infections among untested people, as well those who have been tested. This approach was recently used to calculate widely publicized nationwide HIV incidence estimates.…”

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confidence: 99%

Evaluation of HIV Incidence Surveillance in New York City, 2006

2011

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In 2005, the New York City (NYC) Department of Health and Mental Hygiene implemented a standardized human immunodeficiency virus (HIV) incidence surveillance protocol based on the serologic testing algorithm for recent HIV seroconversion deployed nationwide by the Centers for Disease Control and Prevention (CDC). We evaluated four key attributes of NYC's HIV incidence surveillance system-simplicity, data quality, timeliness, and acceptability--using CDC's guidelines for surveillance system evaluation. The evaluation revealed that the system could potentially provide HIV incidence estimates stratified by borough and major demographic groups at about nine months after the period of interest. The system strengths include its relative simplicity and integration with routine HIV/acquired immunodeficiency syndrome surveillance. Weaknesses include lack of completeness of testing history information, a critical component of incidence estimation. Continued improvements in data completeness and timeliness will improve the currently available information to inform personnel who develop HIV-prevention programs and policy initiatives in NYC and nationally.

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High Incidence of HIV-1 in South Africa Using a Standardized Algorithm for Recent HIV Seroconversion

Cited by 8 publications

References 14 publications

External infections contribute minimally to HIV incidence among HIV sero-discordant couples in sub-Saharan Africa

External infections contribute minimally to HIV incidence among HIV sero-discordant couples in sub-Saharan Africa

Temporal trends in the incidence of HIV infection in antenatal clinic attendees in Addis Ababa, Ethiopia, 1995–2003

Evaluation of HIV Incidence Surveillance in New York City, 2006

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