Insights into the rise in HIV infections, 2001 to 2008: a Bayesian synthesis of prevalence evidence
Insights into the rise in HIV infections, 2001 to 2008: a Bayesian synthesis of prevalence evidence
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2001 年至 2008 年艾滋病毒感染上升的见解：流行率证据的贝叶斯综合
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发表时间：
2010
期刊：
影响因子：
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通讯作者：
D. De Angelis
中科院分区：
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作者：
A. Presanis;O. Gill;T. Chadborn;C. Hill;V. Hope;L. Logan;Brian D Rice;V. Delpech;A. Ades;D. De Angelis
目的：估计自 2001 年以来英格兰和威尔士 15-44 岁成年人中艾滋病毒感染率（未确诊感染率和总感染率）的趋势。设计：多个监测系统和调查数据可用于了解英格兰和威尔士艾滋病毒流行的不同方面。为了连贯一致地结合这些信息来估计艾滋病毒流行趋势，我们在贝叶斯统计框架中应用了多参数证据综合。方法：研究人群按暴露组和居住地区进行分层。我们综合了行为和社区调查、不相关的匿名血清流行率调查以及对确诊艾滋病毒感染者的年度调查的数据。患病率估计值的可信区间为 95%。结果：15-44 岁人群中艾滋病毒感染流行人数估计已从 2001 年的 32 400 人（29 600-35 900 人）增加到 2008 年的 54 500 人（50 500-59 100 人），相当于每 1000 人中 1.5 人（1.4-1.7 人）的估计患病率上升到每 1000 人中 2.4 人。 2008 年为 1000 (2.3–2.6)。诊断感染率的上升在很大程度上导致了这一增长。没有证据表明未确诊感染的患病率在统计上显着下降。因此，确诊感染的比例也有所增加。结论：虽然确诊感染比例的增加令人鼓舞，但艾滋病毒患病率的上升以及未确诊感染患病率下降的证据不足表明，诊断率还不足以减少不知道自己感染的人数，并且肯定会出现新的感染。
Objective:To estimate trends in prevalence of HIV infection, undiagnosed and total, among adults aged 15–44 years in England and Wales since 2001. Design:Multiple surveillance systems and survey data are available to inform different aspects of the HIV epidemic in England and Wales. To coherently and consistently combine this information to estimate trends in HIV prevalence, we apply a multiparameter evidence synthesis in a Bayesian statistical framework. Methods:The study population is stratified by exposure group and region of residence. We synthesize data from behavioural and community surveys, unlinked anonymous seroprevalence surveys, and an annual survey of individuals with diagnosed HIV infection. Prevalence estimates are given with 95% credible intervals. Results:The estimated number of prevalent HIV infections in 15–44-year-olds has increased from 32 400 (29 600–35 900) in 2001 to 54 500 (50 500–59 100) in 2008, corresponding to an estimated prevalence of 1.5 per 1000 (1.4–1.7) rising to 2.4 per 1000 (2.3–2.6) in 2008. A rise in prevalence of diagnosed infection contributes substantially to the increase. There is no evidence of a statistically significant decrease in the prevalence of undiagnosed infection. The proportion of infections that are diagnosed has therefore also increased. Conclusion:Although the increase in the proportion of infections that are diagnosed is encouraging, the rise in HIV prevalence and lack of evidence of a decrease in prevalence of undiagnosed infection suggest that diagnosis rates are not high enough to reduce the pool of individuals unaware of their infection and that new infections must be occurring.