Rosenberg P S, Biggar R J, Goedert J J, Gail M H
Epidemiologic Methods Section, National Cancer Institute, Rockville, MD 20892.
Am J Epidemiol. 1991 Feb 1;133(3):276-85. doi: 10.1093/oxfordjournals.aje.a115872.
The method of backcalculation was applied to national surveillance data on the acquired immunodeficiency syndrome (AIDS) in order to estimate the cumulative number of adults with human immunodeficiency virus type 1 (HIV-1) infection as of January 1, 1985 and July 1, 1987. A "plausible range" of estimates was constructed which reflected both uncertainty about the AIDS incubation distribution and random variation from selection and fitting of flexible models of the HIV-1 infection curve. The authors estimated that, as of 1985, 411,000 to 756,000 persons were infected. The infected population included 266,000 to 492,000 homosexual men, 69,000 to 136,000 intravenous drug users, 24,000 to 49,000 homosexual intravenous drug users, and 11,000 to 26,000 persons infected through heterosexual contact. The estimated prevalence of infection among persons aged 15-55 years was 0.31% in whites, 0.78% in Hispanics, and 0.81% in blacks. An estimated 32,000 to 66,000 women were infected. Compared with white women aged 15-55 years, the prevalence of infection was 5.3-fold higher in Hispanic women and 10.2-fold higher in black women. Plausible estimates for the total number infected by July 1987 ranged from 707,000 to 1,376,000, with the most likely estimate equal to 992,000. Backcalculation provides an assessment of the magnitude of the HIV-1 epidemic that is independent of estimates based on prevalence surveys in special populations. The estimates obtained from both methods are consistent and emphasize the need for vigorous programs to prevent the spread of HIV-1, especially in minority communities.
反向推算方法被应用于全国获得性免疫缺陷综合征（艾滋病）监测数据，以估计截至1985年1月1日和1987年7月1日感染1型人类免疫缺陷病毒（HIV-1）的成年人累计数量。构建了一个“合理范围”的估计值，该估计值既反映了艾滋病潜伏期分布的不确定性，也反映了从HIV-1感染曲线灵活模型的选择和拟合中产生的随机变化。作者估计，截至1985年，有41.1万至75.6万人受到感染。受感染人群包括26.6万至49.2万同性恋男性、6.9万至13.6万静脉注射吸毒者、2.4万至4.9万同性恋静脉注射吸毒者，以及1.1万至2.6万通过异性接触感染的人。估计15至55岁人群中的感染率在白人中为0.31%，在西班牙裔中为0.78%，在黑人中为0.81%。估计有3.2万至6.6万女性受到感染。与15至55岁的白人女性相比，西班牙裔女性的感染率高5.3倍，黑人女性的感染率高10.2倍。到1987年7月1日，估计的总感染人数合理范围为70.7万至137.6万，最可能的估计数为99.2万。反向推算提供了对HIV-1流行规模的评估，该评估独立于基于特殊人群患病率调查的估计。从这两种方法获得的估计值是一致的，并强调需要大力开展预防HIV-1传播的项目，特别是在少数族裔社区。
