Adjusting HIV prevalence data from a program for the prevention of mother-to-child transmission for surveillance purposes in Uganda
Adjusting HIV prevalence data from a program for the prevention of mother-to-child transmission for surveillance purposes in Uganda
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DOI：
10.1097/qai.0b013e31815724e7
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发表时间：
2007-11-01
影响因子：
3.6
通讯作者：
Declich, Silvia
中科院分区：
文献类型：
--
作者：
Fabiani, Massimo;Yoti, Zabulon;Declich, Silvia
目的：评估一种基于预防母婴传播（PMTCT）艾滋病毒感染项目数据调整艾滋病毒流行率估计的方法，以避免因拒绝PMTCT相关检测而导致的潜在偏差。方法：使用年龄特异性逻辑回归模型来估计乌干达北部产前诊所接受pmtct相关检测的妇女（n = 1874）的10个预测变量的艾滋病毒风险系数。这些风险系数用于预测未接受检测的女性的患病率（n = 1719），并调整基于预防母婴传播的患病率以消除不参与偏倚。将基于预防母婴传播的粗糙和调整后的患病率估计值与作为常规哨点监测一部分匿名检测的女性患病率进行比较（n = 2225）。结果：与2004年匿名监测相比，基于预防母婴传播的流行率被低估了（9.0%对10.5%）；2005年，这一比例被高估了（11.8% vs. 10.9%）。对基于预防母婴传播的流行率进行调整后，两年内因不参与偏见造成的差异减少了约70%，因此调整后的流行率（2004年为10.1%，2005年为11.2%）与基于监测的流行率相似。结论：调整方法可有效减少不参与偏倚。需要进一步的研究来评估预防母婴传播项目数据对艾滋病毒监测的效用。
Objectives: To evaluate a method for adjusting estimates of HIV prevalence based on data from a program for the prevention of mother-to-child transmission (PMTCT) of HIV infection for the potential bias attributable to refusal of PMTCT-related testing.Methods: Age-specific logistic regression models were used to estimate the HIV risk coefficients for 10 predictor variables among women who accepted the PMTCT-related testing (n = 1874) at an antenatal clinic in northern Uganda. These risk coefficients were used to predict the prevalence among women who were not tested (n = 1719) and to adjust the PMTCT-based prevalence for nonparticipation bias. Crude and adjusted PMTCT-based prevalence estimates were compared with the prevalence among women who were anonymously tested as part of routine sentinel surveillance (n = 2225).Results: The PMTCT-based prevalence represented an underestimate compared with that based on anonymous surveillance in 2004 (9.0% vs. 10.5%); in 2005, it constituted an overestimate (11.8% vs. 10.9%). Adjusting the PMTCT-based prevalence reduced the difference attributable to nonparticipation bias by approximately 70% in both years, so that the adjusted prevalence (10.1% in 2004 and 11.2% in 2005) was similar to the surveillance-based prevalence.Conclusions: The adjustment method was effective in reducing the nonparticipation bias. Further studies are needed to assess the utility of PMTCT program data for HIV surveillance.