Estimation of HIV Incidence in the United States Export

@article{citeulike:6075853, abstract = {Context Incidence of human immunodeficiency virus (HIV) in the United States has not been directly measured. New assays that differentiate recent vs long-standing HIV infections allow improved estimation of HIV incidence. Objective To estimate HIV incidence in the United States. Design, Setting, and Patients Remnant diagnostic serum specimens from patients 13 years or older and newly diagnosed with HIV during 2006 in 22 states were tested with the BED HIV-1 capture enzyme immunoassay to classify infections as recent or long-standing. Information on HIV cases was reported to the Centers for Disease Control and Prevention through June 2007. Incidence of HIV in the 22 states during 2006 was estimated using a statistical approach with adjustment for testing frequency and extrapolated to the United States. Results were corroborated with back-calculation of HIV incidence for 1977-2006 based on HIV diagnoses from 40 states and AIDS incidence from 50 states and the District of Columbia. Main Outcome Measure Estimated HIV incidence. Results An estimated 39 400 persons were diagnosed with HIV in 2006 in the 22 states. Of 6864 diagnostic specimens tested using the BED assay, 2133 (31\%) were classified as recent infections. Based on extrapolations from these data, the estimated number of new infections for the United States in 2006 was 56 300 (95\% confidence interval [CI], 48 200-64 500); the estimated incidence rate was 22.8 per 100 000 population (95\% CI, 19.5-26.1). Forty-five percent of infections were among black individuals and 53\% among men who have sex with men. The back-calculation (n = 1.230 million HIV/AIDS cases reported by the end of 2006) yielded an estimate of 55 400 (95\% CI, 50 000-60 800) new infections per year for 2003-2006 and indicated that HIV incidence increased in the mid-1990s, then slightly declined after 1999 and has been stable thereafter. Conclusions This study provides the first direct estimates of HIV incidence in the United States using laboratory technologies previously implemented only in clinic-based settings. New HIV infections in the United States remain concentrated among men who have sex with men and among black individuals. 10.1001/jama.300.5.520}, author = {Hall, H. Irene and Song, Ruiguang and Rhodes, Philip and Prejean, Joseph and An, Qian and Lee, Lisa M. and Karon, John and Brookmeyer, Ron and Kaplan, Edward H. and McKenna, Matthew T. and Janssen, Robert S. and for the HIV Incidence Surveillance Group}, citeulike-article-id = {6075853}, citeulike-linkout-0 = {http://dx.doi.org/10.1001/jama.300.5.520}, citeulike-linkout-1 = {http://jama.ama-assn.org/content/300/5/520.abstract}, citeulike-linkout-2 = {http://jama.ama-assn.org/content/300/5/520.full.pdf}, citeulike-linkout-3 = {http://view.ncbi.nlm.nih.gov/pubmed/18677024}, citeulike-linkout-4 = {http://www.hubmed.org/display.cgi?uids=18677024}, day = {6}, doi = {10.1001/jama.300.5.520}, journal = {JAMA}, keywords = {hiv, incidence, usa}, month = {August}, number = {5}, pages = {520--529}, posted-at = {2009-11-05 18:04:32}, priority = {2}, title = {Estimation of HIV Incidence in the United States}, url = {http://dx.doi.org/10.1001/jama.300.5.520}, volume = {300}, year = {2008} }

TY - JOUR ID - citeulike:6075853 L3 - citeulike-article-id:6075853 N2 - Context Incidence of human immunodeficiency virus (HIV) in the United States has not been directly measured. New assays that differentiate recent vs long-standing HIV infections allow improved estimation of HIV incidence. Objective To estimate HIV incidence in the United States. Design, Setting, and Patients Remnant diagnostic serum specimens from patients 13 years or older and newly diagnosed with HIV during 2006 in 22 states were tested with the BED HIV-1 capture enzyme immunoassay to classify infections as recent or long-standing. Information on HIV cases was reported to the Centers for Disease Control and Prevention through June 2007. Incidence of HIV in the 22 states during 2006 was estimated using a statistical approach with adjustment for testing frequency and extrapolated to the United States. Results were corroborated with back-calculation of HIV incidence for 1977-2006 based on HIV diagnoses from 40 states and AIDS incidence from 50 states and the District of Columbia. Main Outcome Measure Estimated HIV incidence. Results An estimated 39 400 persons were diagnosed with HIV in 2006 in the 22 states. Of 6864 diagnostic specimens tested using the BED assay, 2133 (31%) were classified as recent infections. Based on extrapolations from these data, the estimated number of new infections for the United States in 2006 was 56 300 (95% confidence interval [CI], 48 200-64 500); the estimated incidence rate was 22.8 per 100 000 population (95% CI, 19.5-26.1). Forty-five percent of infections were among black individuals and 53% among men who have sex with men. The back-calculation (n = 1.230 million HIV/AIDS cases reported by the end of 2006) yielded an estimate of 55 400 (95% CI, 50 000-60 800) new infections per year for 2003-2006 and indicated that HIV incidence increased in the mid-1990s, then slightly declined after 1999 and has been stable thereafter. Conclusions This study provides the first direct estimates of HIV incidence in the United States using laboratory technologies previously implemented only in clinic-based settings. New HIV infections in the United States remain concentrated among men who have sex with men and among black individuals. 10.1001/jama.300.5.520 IS - 5 JF - JAMA EP - 529 TI - Estimation of HIV Incidence in the United States VL - 300 SP - 520 KW - hiv KW - incidence KW - usa AU - Hall, Irene AU - Song, Ruiguang AU - Rhodes, Philip AU - Prejean, Joseph AU - An, Qian AU - Lee, Lisa AU - Karon, John AU - Brookmeyer, Ron AU - Kaplan, Edward AU - McKenna, Matthew AU - Janssen, Robert AU - for the HIV Incidence Surveillance Group PY - 2008/08/06/ UR - http://dx.doi.org/10.1001/jama.300.5.520 ER -