Stover John, Brown Tim, Puckett Robert, Peerapatanapokin Wiwat
aAvenir Health, Glastonbury, Connecticut bEast West Center, Honolulu, Hawaii, USA.
AIDS. 2017 Apr;31 Suppl 1:S5-S11. doi: 10.1097/QAD.0000000000001322.
BACKGROUND: The Spectrum model is used by national programs and UNAIDS to prepare annual estimates of the status of the HIV epidemic in 160 countries. The model and assumptions are updated regularly under the guidance of the UNAIDS Reference Group on Estimates, Modelling and Projections in response to new data, studies, and program needs. This study describes the most recent updates for the 2016 round of estimates. METHODS: Meetings of the UNAIDS Reference Group include individuals with extensive knowledge of HIV programs, research, statistics, and public policy. The Reference Group also collaborates with other institutions (such as the United Nations Population Division and the US Census Bureau) and projects (such as the ALPHA Network and IeDEA Consortium) to ensure that latest methods and data are used in the preparation of the annual estimates. In the past year new methods and data have been introduced for pediatric estimates, incidence fitting, and ART mortality (described elsewhere in this supplement). RESULTS: The 2016 version of Spectrum includes a number of other enhancements, including updated demographic data from the United Nations Population Division, program options for treatment (treat all), and programs to prevent mother-to-child transmission (option B+), improved methods to aggregate uncertainty to regional and global levels, several options for generating incidence trends, adjustments to the Estimations and Projections Package model to better incorporate aging effects, adjustments to account for the changing bias in prevalence from antenatal clinic surveillance, and an option to fit incidence among all adults 15+ in addition to 15-49. CONCLUSION: The new methods and data implemented in the 2016 version of Spectrum allow national programs more flexibility in describing their programs and improve the estimates of key indicators and their uncertainty.
背景:“光谱”模型被各国项目及联合国艾滋病规划署用于编制160个国家艾滋病流行状况的年度估算。该模型及其假设会在联合国艾滋病规划署估算、建模与预测参考小组的指导下,根据新数据、研究及项目需求定期更新。本研究描述了2016年估算轮次的最新更新情况。 方法:联合国艾滋病规划署参考小组的会议成员包括在艾滋病项目、研究、统计及公共政策方面具备丰富知识的人员。该参考小组还与其他机构(如联合国人口司和美国人口普查局)及项目(如阿尔法网络和国际流行病学数据库与评估协作组)合作,以确保在编制年度估算时采用最新方法和数据。过去一年,在儿科估算、发病率拟合及抗逆转录病毒治疗死亡率方面引入了新方法和数据(本增刊其他地方有描述)。 结果:2016版“光谱”模型还有多项其他改进,包括更新了联合国人口司的人口数据、治疗方案选项(治疗所有人)及预防母婴传播方案(选项B+),改进了将不确定性汇总至区域和全球层面的方法,生成发病率趋势的多种选项,对估算与预测软件包模型进行调整以更好地纳入老龄化影响,调整以考虑产前诊所监测中患病率不断变化的偏差,以及除了15 - 49岁成年人外还可拟合15岁及以上所有成年人发病率的选项。 结论:2016版“光谱”模型中实施的新方法和数据使各国项目在描述其项目时有更大灵活性,并改进了关键指标的估算及其不确定性。
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