Estimating Sizes of Key Populations at the National Level: Considerations for Study Design and Analysis.
Estimating Sizes of Key Populations at the National Level: Considerations for Study Design and Analysis.
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DOI：
10.1097/ede.0000000000000906
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发表时间：
2018-11
期刊：
影响因子：
--
通讯作者：
Weir SS
中科院分区：
文献类型：
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作者：
Edwards JK;Hileman S;Donastorg Y;Zadrozny S;Baral S;Hargreaves JR;Fearon E;Zhao J;Datta A;Weir SS
各国对包括女性性工作者、男男性行为者和变性妇女在内的关键人群规模的估计，对于为国家和国际应对艾滋病毒流行病提供信息至关重要。然而，流行病学研究通常只提供有限的高优先级地理区域的规模估计。本文说明了一个两阶段的方法来获得一个国家的关键人口规模估计在多米尼加共和国使用现有的估计和公开的背景信息。在其他地区有针对性地收集更多数据，从而扩大了对优先地区关键人口规模的现有估计。为了联合收割机从每个阶段收集的数据中获得信息，我们使用了统计方法来处理缺失数据，包括逆概率权重、多重插补和增强的逆概率权重。使用增强的逆概率加权方法，它提供了一些保护，防止参数模型误设定，我们估计，3.7%，多米尼加共和国15至49岁的妇女总人口中从事性工作的占1.2%（95% CI = 2.9，4.7），（95% CI = 1.1，1.3）的15-49岁男性与其他男性发生性关系，0.19%（95% CI = 0.17，0.21）的人在出生时被指定为男性性别的人是变性人。将关键人口的规模估计视为缺失数据问题，为阐明和评估获得国家规模估计所需的假设提供了一个框架。此外，这种范式允许使用流行病学家熟悉的缺失数据的方法。
National estimates of the sizes of key populations, including female sex workers, men who have sex with men, and transgender women are critical to inform national and international responses to the HIV pandemic. However, epidemiologic studies typically provide size estimates for only limited high priority geographic areas. This article illustrates a two-stage approach to obtain a national key population size estimate in the Dominican Republic using available estimates and publicly available contextual information. Available estimates of key population size in priority areas were augmented with targeted additional data collection in other areas. To combine information from data collected at each stage, we used statistical methods for handling missing data, including inverse probability weights, multiple imputation, and augmented inverse probability weights. Using the augmented inverse probability weighting approach, which provides some protection against parametric model misspecification, we estimated that 3.7% (95% CI = 2.9, 4.7) of the total population of women in the Dominican Republic between the ages of 15 and 49 years were engaged in sex work, 1.2% (95% CI = 1.1, 1.3) of men aged 15–49 had sex with other men, and 0.19% (95% CI = 0.17, 0.21) of people assigned the male sex at birth were transgender. Viewing the size estimation of key populations as a missing data problem provides a framework for articulating and evaluating the assumptions necessary to obtain a national size estimate. In addition, this paradigm allows use of methods for missing data familiar to epidemiologists.