Estimation of HIV-1 Incidence Using a Testing History-Based Method; Analysis From the Population-Based HIV Impact...

Area of Science:

• Epidemiology
• Public Health
• Infectious Disease Modeling

Background:

• Accurate estimation of Human Immunodeficiency Virus (HIV) incidence is crucial for monitoring epidemic control in sub-Saharan Africa.
• Traditional methods rely on laboratory-based incidence assays, but an alternative using testing history has emerged.

Purpose of the Study:

• To evaluate a novel HIV incidence estimation method based on patient testing history.
• To compare its accuracy and precision against established laboratory-based incidence assays.

Main Methods:

• Applied a testing history-based HIV incidence estimation method to cross-sectional survey data from 12 sub-Saharan African countries.
• Compared estimates with those derived from laboratory-based incidence assays using national rapid test algorithms and detailed testing history.

Main Results:

• The testing history method showed strong correlation (ρ = 0.85) with laboratory-based incidence assay estimates.
• This method yielded more precise incidence estimates and identified key demographic differences (sex, age, location) not found by the biomarker method.

Conclusions:

• The testing history-based method is a precise and valuable tool for estimating and validating HIV incidence from survey data.
• It provides informative age- and sex-specific estimates crucial for targeted programmatic decisions and inter/intra-country comparisons.