OBJECTIVE: To estimate trends in prevalence of HIV infection, undiagnosed and total, among adults aged 15-44 years in England and Wales since 2001. DESIGN: Multiple surveillance systems and survey data are available to inform different aspects of the HIV epidemic in England and Wales. To coherently and consistently combine this information to estimate trends in HIV prevalence, we apply a multiparameter evidence synthesis in a Bayesian statistical framework. METHODS: The study population is stratified by exposure group and region of residence. We synthesize data from behavioural and community surveys, unlinked anonymous seroprevalence surveys, and an annual survey of individuals with diagnosed HIV infection. Prevalence estimates are given with 95% credible intervals. RESULTS: The estimated number of prevalent HIV infections in 15-44-year-olds has increased from 32,400 (29,600-35,900) in 2001 to 54,500 (50,500-59,100) in 2008, corresponding to an estimated prevalence of 1.5 per 1000 (1.4-1.7) rising to 2.4 per 1000 (2.3-2.6) in 2008. A rise in prevalence of diagnosed infection contributes substantially to the increase. There is no evidence of a statistically significant decrease in the prevalence of undiagnosed infection. The proportion of infections that are diagnosed has therefore also increased. CONCLUSION: Although the increase in the proportion of infections that are diagnosed is encouraging, the rise in HIV prevalence and lack of evidence of a decrease in prevalence of undiagnosed infection suggest that diagnosis rates are not high enough to reduce the pool of individuals unaware of their infection and that new infections must be occurring.
OBJECTIVE: To estimate trends in prevalence of HIV infection, undiagnosed and total, among adults aged 15-44 years in England and Wales since 2001. DESIGN: Multiple surveillance systems and survey data are available to inform different aspects of the HIV epidemic in England and Wales. To coherently and consistently combine this information to estimate trends in HIV prevalence, we apply a multiparameter evidence synthesis in a Bayesian statistical framework. METHODS: The study population is stratified by exposure group and region of residence. We synthesize data from behavioural and community surveys, unlinked anonymous seroprevalence surveys, and an annual survey of individuals with diagnosed HIV infection. Prevalence estimates are given with 95% credible intervals. RESULTS: The estimated number of prevalent HIV infections in 15-44-year-olds has increased from 32,400 (29,600-35,900) in 2001 to 54,500 (50,500-59,100) in 2008, corresponding to an estimated prevalence of 1.5 per 1000 (1.4-1.7) rising to 2.4 per 1000 (2.3-2.6) in 2008. A rise in prevalence of diagnosed infection contributes substantially to the increase. There is no evidence of a statistically significant decrease in the prevalence of undiagnosed infection. The proportion of infections that are diagnosed has therefore also increased. CONCLUSION: Although the increase in the proportion of infections that are diagnosed is encouraging, the rise in HIV prevalence and lack of evidence of a decrease in prevalence of undiagnosed infection suggest that diagnosis rates are not high enough to reduce the pool of individuals unaware of their infection and that new infections must be occurring.
Authors: Kirsty M Mair; Audrey F Wright; Nicholas Duggan; David J Rowlands; Martin J Hussey; Sonia Roberts; Josephine Fullerton; Margaret Nilsen; Lynn Loughlin; Matthew Thomas; Margaret R MacLean Journal: Am J Respir Crit Care Med Date: 2014-08-15 Impact factor: 21.405
Authors: Narat Punyacharoensin; William John Edmunds; Daniela De Angelis; Richard Guy White Journal: Eur J Epidemiol Date: 2011-09-20 Impact factor: 8.082
Authors: Eline L M Op de Coul; Imke Schreuder; Stefano Conti; Ard van Sighem; Maria Xiridou; Maaike G Van Veen; Janneke C M Heijne Journal: PLoS One Date: 2015-07-17 Impact factor: 3.240
Authors: Paul J Birrell; O Noel Gill; Valerie C Delpech; Alison E Brown; Sarika Desai; Tim R Chadborn; Brian D Rice; Daniela De Angelis Journal: Lancet Infect Dis Date: 2013-02-01 Impact factor: 25.071
Authors: Andrew N Phillips; Valentina Cambiano; Fumiyo Nakagawa; Alison E Brown; Fiona Lampe; Alison Rodger; Alec Miners; Jonathan Elford; Graham Hart; Anne M Johnson; Jens Lundgren; Valerie C Delpech Journal: PLoS One Date: 2013-02-15 Impact factor: 3.240
Authors: David Dolling; Caroline Sabin; Valerie Delpech; Erasmus Smit; Anton Pozniak; David Asboe; Andrew Leigh Brown; Duncan Churchill; Ian Williams; Anna Maria Geretti; Andrew Phillips; Nicola Mackie; Gary Murphy; Hannah Castro; Deenan Pillay; Patricia Cane; David Dunn; David Dolling Journal: BMJ Date: 2012-08-21