Measuring the HIV Care Continuum Using Public Health Surveillance Data in the United States
Measuring the HIV Care Continuum Using Public Health Surveillance Data in the United States
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DOI：
10.1097/qai.0000000000000788
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发表时间：
2015-12-15
影响因子：
3.6
通讯作者：
Powers, Kimberly A.
中科院分区：
文献类型：
--
作者：
Lesko, Catherine R.;Sampson, Lynne A.;Powers, Kimberly A.
艾滋病毒护理连续体是艾滋病毒流行状况认识的重要框架；然而，准确计算连续体成分所面临的挑战阻碍了实践中的连续体估计。我们描述了美国基于当地监测的艾滋病毒连续体估计，回顾了疾病控制和预防中心建议的常见做法。此外，我们回顾了可能威胁现有连续统估计的一些挑战和偏见。目前的估计在很大程度上依赖于使用向监测项目报告的 CD4 细胞计数和 HIV 病毒载量实验室结果作为接受 HIV 相关门诊护理的替代指标。因此，由于实验室报告不完整，并且作为常规艾滋病毒护理指标的实验室检测的敏感性和特异性不完善，连续估计很容易出现偏差。艾滋病毒感染者在司法管辖区之间的迁移也威胁到连续估计的有效性。数据三角测量可能会改善但不能完全消除偏差。
The HIV care continuum is a critical framework for situational awareness of the HIV epidemic; yet challenges to accurate enumeration of continuum components hamper continuum estimation in practice. We describe local surveillance-based estimation of the HIV continuum in the United States, reviewing common practices as recommended by the Centers for Disease Control and Prevention. Furthermore, we review some challenges and biases likely to threaten existing continuum estimates. Current estimates rely heavily on the use of CD4 cell count and HIV viral load laboratory results reported to surveillance programs as a proxy for receipt of HIV-related outpatient care. As such, continuum estimates are susceptible to bias because of incomplete laboratory reporting and imperfect sensitivity and specificity of laboratory tests as a proxy for routine HIV care. Migration of HIV-infected persons between jurisdictions also threatens the validity of continuum estimates. Data triangulation may improve but not fully alleviate biases.