Sheng Ben, Eaton Jeffrey W, Mahy Mary, Bao Le
Department of Statistics, Pennsylvania State University, 325 Thomas Building, University Park, PA 16802, USA.
Department of Infectious Disease Epidemiology, Imperial College London, St Mary's Campus, Norfolk Place, London W2 1PG, United Kingdom.
Stat Biosci. 2020 Dec;12(3):279-294. doi: 10.1007/s12561-020-09265-4. Epub 2020 Feb 28.
In 2015, WHO and UNAIDS released new guidance recommending that countries transition from conducting antenatal clinic (ANC) unlinked anonymous testing (ANC-UAT) for tracking HIV prevalence trends among pregnant women to using ANC routine testing (ANC-RT) data, which are more consistent and economic to collect. This transition could pose challenges for distinguishing whether changes in observed prevalence are due to a change in underlying population prevalence or due to a change in the testing approach. We compared the HIV prevalence measured from ANC-UAT and ANCRT in 15 countries that had both data sources in overlapping years. We used linear mixed-e effects model (LMM) to estimate the RT-to-UAT calibration parameter as well as other unobserved quantities. We summarized the results at different levels of aggregation (e.g., country, urban, rural, and province). Based on our analysis, the HIV prevalence measured by ANC-UAT and ANC-RT data are consistent in most countries. Therefore, if large discrepancy is observed between ANC-UAT and ANC-RT at the same location, we recommend that people should be cautious and investigate the reason. For countries that lack information to estimate the calibration parameter, we propose an informative prior distribution of mean 0 and standard deviation 0.2 for the RT-to-UAT calibration parameter.
2015年，世界卫生组织（WHO）和联合国艾滋病规划署（UNAIDS）发布了新指南，建议各国从开展用于追踪孕妇中艾滋病毒流行趋势的产前诊所（ANC）非关联匿名检测（ANC-UAT），转向使用更易于收集且一致的ANC常规检测（ANC-RT）数据。这种转变可能给区分观察到的流行率变化是由于潜在人群流行率的变化还是检测方法的变化带来挑战。我们比较了15个在重叠年份同时拥有这两种数据来源的国家中，通过ANC-UAT和ANC-RT测得的艾滋病毒流行率。我们使用线性混合效应模型（LMM）来估计RT到UAT的校准参数以及其他未观察到的量。我们在不同的汇总层面（如国家、城市、农村和省份）总结了结果。基于我们的分析，在大多数国家，通过ANC-UAT和ANC-RT测得的艾滋病毒流行率是一致的。因此，如果在同一地点观察到ANC-UAT和ANC-RT之间存在较大差异，我们建议人们应谨慎并调查原因。对于缺乏信息来估计校准参数的国家，我们为RT到UAT校准参数提出了均值为0、标准差为0.2的信息性先验分布。
