Sheng Ben, Marsh Kimberly, Slavkovic Aleksandra B, Gregson Simon, Eaton Jeffrey W, Bao Le
aDepartment of Statistics, Pennsylvania State University, University Park, Pennsylvania, USA bStrategic Information and Monitoring Division, UNAIDS, Geneva, Switzerland cDepartment of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom.
AIDS. 2017 Apr;31 Suppl 1(Suppl 1):S87-S94. doi: 10.1097/QAD.0000000000001428.
HIV prevalence data collected from routine HIV testing of pregnant women at antenatal clinics (ANC-RT) are potentially available from all facilities that offer testing services to pregnant women and can be used to improve estimates of national and subnational HIV prevalence trends. We develop methods to incorporate these new data source into the Joint United Nations Programme on AIDS Estimation and Projection Package in Spectrum 2017.
We develop a new statistical model for incorporating ANC-RT HIV prevalence data, aggregated either to the health facility level (site-level) or regionally (census-level), to estimate HIV prevalence alongside existing sources of HIV prevalence data from ANC unlinked anonymous testing (ANC-UAT) and household-based national population surveys. Synthetic data are generated to understand how the availability of ANC-RT data affects the accuracy of various parameter estimates.
We estimate HIV prevalence and additional parameters using both ANC-RT and other existing data. Fitting HIV prevalence using synthetic data generally gives precise estimates of the underlying trend and other parameters. More years of ANC-RT data should improve prevalence estimates. More ANC-RT sites and continuation with existing ANC-UAT sites may improve the estimate of calibration between ANC-UAT and ANC-RT sites.
We have proposed methods to incorporate ANC-RT data into Spectrum to obtain more precise estimates of prevalence and other measures of the epidemic. Many assumptions about the accuracy, consistency, and representativeness of ANC-RT prevalence underlie the use of these data for monitoring HIV epidemic trends and should be tested as more data become available from national ANC-RT programs.
从产前诊所对孕妇进行的常规艾滋病毒检测（ANC-RT）中收集的艾滋病毒流行率数据，有可能从所有为孕妇提供检测服务的机构获取，并且可用于改进对国家和次国家层面艾滋病毒流行趋势的估计。我们开发了将这些新数据源纳入《2017年艾滋病规划署联合规划署艾滋病估计与预测软件包》的方法。
我们开发了一种新的统计模型，用于纳入在医疗机构层面（机构层面）或区域层面（普查层面）汇总的ANC-RT艾滋病毒流行率数据，以便与来自产前未关联匿名检测（ANC-UAT）和基于家庭的全国人口调查的现有艾滋病毒流行率数据来源一起估计艾滋病毒流行率。生成合成数据以了解ANC-RT数据的可用性如何影响各种参数估计的准确性。
我们使用ANC-RT和其他现有数据估计艾滋病毒流行率及其他参数。使用合成数据拟合艾滋病毒流行率通常能对潜在趋势和其他参数给出精确估计。更多年份的ANC-RT数据应能改进流行率估计。更多的ANC-RT机构以及继续保留现有的ANC-UAT机构可能会改进对ANC-UAT和ANC-RT机构之间校准的估计。
我们提出了将ANC-RT数据纳入Spectrum的方法，以获得对流行率和该流行病其他指标更精确的估计。关于ANC-RT流行率的准确性、一致性和代表性的许多假设是使用这些数据监测艾滋病毒流行趋势的基础，随着国家ANC-RT项目获得更多数据，应进行检验。
