Fife D, Mode C
AIDS Activities Coordinating Office, Philadelphia Department of Public Health, PA 19107.
J Acquir Immune Defic Syndr (1988). 1992;5(11):1111-5.
We sought to track recent changes in AIDS incidence and prevalence in the city of Philadelphia (PA, U.S.A.) using morbidity and mortality data reported to the health department. We stratified the data by the mean per capita income in census tracts where people with AIDS resided. Estimates made without adjustment for the time lag between events and their entry into the database undercount both recent AIDS diagnoses and recent AIDS deaths. Therefore, we used a previously published method to adjust for the lag in reporting diagnoses and developed a method to adjust for the lag in reporting deaths. We calculated prevalent cases as the difference between cumulative cases and cumulative deaths. Between 1988 and 1990, annual AIDS incidence per 100,000 Philadelphia residents increased by 21% (from 25.9 to 31.4) and AIDS prevalence per 100,000 population increased by 62% (from 30.2 to 48.8). AIDS prevalence increased 113% (from 29.8 to 63.6) in low-income tracts, 88% (from 27.8 to 52.3) in middle-income tracts, and 14% (from 32.5 to 37.2) in high-income tracts. The 62% increase in AIDS prevalence and the shift toward people in poorer neighborhoods imply a need for public funding for AIDS care that is far larger than would be suggested by the general 21% increase in AIDS incidence over the same period.
我们试图利用向卫生部门报告的发病率和死亡率数据，追踪美国宾夕法尼亚州费城艾滋病发病率和患病率的近期变化。我们根据艾滋病患者居住的普查区的人均收入均值对数据进行分层。在未对事件与数据录入数据库之间的时间滞后进行调整的情况下所做的估计，会低估近期的艾滋病诊断病例数和近期的艾滋病死亡人数。因此，我们采用了先前发表的一种方法来调整诊断报告的滞后时间，并开发了一种方法来调整死亡报告的滞后时间。我们将现患病例数计算为累积病例数与累积死亡数之差。1988年至1990年期间，费城每10万居民的艾滋病年发病率上升了21%（从25.9升至31.4），每10万人口的艾滋病患病率上升了62%（从30.2升至48.8）。低收入地区的艾滋病患病率上升了113%（从29.8升至63.6），中等收入地区上升了88%（从27.8升至52.3），高收入地区上升了14%（从32.5升至37.2）。艾滋病患病率上升62%以及患病者向较贫困社区转移，这意味着用于艾滋病护理的公共资金需求远远大于同期艾滋病发病率总体上升21%所表明的需求。
