Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore MD.
Am J Epidemiol. 2019 Dec 31;188(12):2061-2068. doi: 10.1093/aje/kwz211.
In 1984, a large prospective study of the natural history of human immunodeficiency virus (HIV) infection, the Multicenter AIDS Cohort Study (MACS), was established; 10 years later, the Women's Interagency HIV Study (WIHS) was launched. Motivated by the merger and redesign of these long-standing HIV cohort studies in 2019, we review ways in which HIV epidemiology in the United States has transformed over the lives of these studies and how this evolution has influenced planning for enrollment and follow-up. We highlight changes that have occurred in the 3 major domains that are central to epidemiologic science: changes to key populations at highest risk for HIV, refinements in measurement and shifts in the outcomes of interest, and a new era in the tools and approaches that epidemiologists use to synthesize evidence from measurements made on populations. By embracing foundational principles with modern methods, the epidemiologic approach of analyzing the causes and distributions of diseases in contemporaneous populations will continue to advance HIV science over the next decade.
1984 年，一项关于人类免疫缺陷病毒（HIV）感染自然史的大型前瞻性研究——多中心艾滋病队列研究（MACS）成立；10 年后，妇女艾滋病机构间研究（WIHS）启动。受这两项长期 HIV 队列研究合并和重新设计的推动，我们回顾了美国 HIV 流行病学在这些研究期间的变化方式，以及这种演变如何影响入组和随访规划。我们重点介绍了在流行病学科学核心的 3 个主要领域发生的变化：高危 HIV 人群的变化、测量方法的改进以及关注结果的转变，以及流行病学家用于从人群测量中综合证据的工具和方法的新时代。通过将现代方法与基础原理相结合，分析当代人群疾病的病因和分布的流行病学方法将在未来十年继续推动 HIV 科学的发展。
