Brown Tim, Bao Le, Eaton Jeffrey W, Hogan Daniel R, Mahy Mary, Marsh Kimberly, Mathers Bradley M, Puckett Robert
aResearch Program, East-West Center, Honolulu, Hawaii bDepartment of Statistics, Pennsylvania State University, University Park, Pennsylvania, USA cDepartment of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom dDepartment of Health Statistics and Information Systems, World Health Organization eUNAIDS, Geneva, Switzerland fThe Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia.
AIDS. 2014 Nov;28 Suppl 4(4):S415-25. doi: 10.1097/QAD.0000000000000454.
Describe modifications to the latest version of the Joint United Nations Programme on AIDS (UNAIDS) Estimation and Projection Package component of Spectrum (EPP 2013) to improve prevalence fitting and incidence trend estimation in national epidemics and global estimates of HIV burden.
Key changes made under the guidance of the UNAIDS Reference Group on Estimates, Modelling and Projections include: availability of a range of incidence calculation models and guidance for selecting a model; a shift to reporting the Bayesian median instead of the maximum likelihood estimate; procedures for comparison and validation against reported HIV and AIDS data; incorporation of national surveys as an integral part of the fitting and calibration procedure, allowing survey trends to inform the fit; improved antenatal clinic calibration procedures in countries without surveys; adjustment of national antiretroviral therapy reports used in the fitting to include only those aged 15-49 years; better estimates of mortality among people who inject drugs; and enhancements to speed fitting.
The revised models in EPP 2013 allow closer fits to observed prevalence trend data and reflect improving understanding of HIV epidemics and associated data.
Spectrum and EPP continue to adapt to make better use of the existing data sources, incorporate new sources of information in their fitting and validation procedures, and correct for quantifiable biases in inputs as they are identified and understood. These adaptations provide countries with better calibrated estimates of incidence and prevalence, which increase epidemic understanding and provide a solid base for program and policy planning.
描述对联合国艾滋病规划署（UNAIDS）《Spectrum 估计与预测软件包》（EPP 2013）最新版本所做的修改，以改善各国艾滋病流行情况中患病率拟合及发病率趋势估计，以及全球 HIV 负担估计。
在 UNAIDS 估计、建模与预测参考小组的指导下所做的主要修改包括：提供一系列发病率计算模型及模型选择指南；转而报告贝叶斯中位数而非最大似然估计值；与报告的 HIV 和艾滋病数据进行比较及验证的程序；将国家调查纳入拟合与校准程序作为其组成部分，使调查趋势为拟合提供信息；改进无调查国家的产前诊所校准程序；调整拟合中使用的国家抗逆转录病毒疗法报告，仅纳入 15 - 49 岁人群的数据；更好地估计注射吸毒者的死亡率；以及提高拟合速度。
EPP 2013 中的修订模型能更紧密地拟合观察到的患病率趋势数据，并反映出对 HIV 流行情况及相关数据的理解不断加深。
Spectrum 和 EPP 持续进行调整，以便更好地利用现有数据源，在其拟合与验证程序中纳入新的信息来源，并在识别和理解输入数据中的可量化偏差时进行校正。这些调整为各国提供了校准更好的发病率和患病率估计值，增强了对疫情的了解，并为项目和政策规划奠定了坚实基础。
