Don C Des Jarlais1, Kamyar Arasteh1, Courtney McKnight1, Jonathan Feelemyer1, Aimée N C Campbell1, Susan Tross1, Lou Smith1, Hannah L F Cooper1, Holly Hagan1, David Perlman1. 1. Don C. Des Jarlais, Kamyar Arasteh, Courtney McKnight, Jonathan Feelemyer, and David Perlman are with the Baron Edmond de Rothschild Chemical Dependency Institute, Mount Sinai Beth Israel, New York, NY. Aimée N. C. Campbell and Susan Tross are with the Department of Psychiatry, Columbia University, New York, NY. Lou Smith is with the New York State Department of Health, Albany. Hannah L. F. Cooper is with the Department of Behavioral Sciences and Health Education, Rolling School of Public Health, Emory University, Atlanta, GA. Holly Hagan is with the College of Nursing, New York University, New York.
Abstract
OBJECTIVES: To compare methods for estimating low HIV incidence among persons who inject drugs. METHODS: We examined 4 methods in New York City, 2005 to 2014: (1) HIV seroconversions among repeat participants, (2) increase of HIV prevalence by additional years of injection among new injectors, (3) the New York State and Centers for Disease Control and Prevention stratified extrapolation algorithm, and (4) newly diagnosed HIV cases reported to the New York City Department of Health and Mental Hygiene. RESULTS: The 4 estimates were consistent: (1) repeat participants: 0.37 per 100 person-years (PY; 95% confidence interval [CI] = 0.05/100 PY, 1.33/100 PY); (2) regression of prevalence by years injecting: 0.61 per 100 PY (95% CI = 0.36/100 PY, 0.87/100 PY); (3) stratified extrapolation algorithm: 0.32 per 100 PY (95% CI = 0.18/100 PY, 0.46/100 PY); and (4) newly diagnosed cases of HIV: 0.14 per 100 PY (95% CI = 0.11/100 PY, 0.16/100 PY). CONCLUSIONS: All methods appear to capture the same phenomenon of very low and decreasing HIV transmission among persons who inject drugs. Public Health Implications. If resources are available, the use of multiple methods would provide better information for public health purposes.
OBJECTIVES: To compare methods for estimating low HIV incidence among persons who inject drugs. METHODS: We examined 4 methods in New York City, 2005 to 2014: (1) HIV seroconversions among repeat participants, (2) increase of HIV prevalence by additional years of injection among new injectors, (3) the New York State and Centers for Disease Control and Prevention stratified extrapolation algorithm, and (4) newly diagnosed HIV cases reported to the New York City Department of Health and Mental Hygiene. RESULTS: The 4 estimates were consistent: (1) repeat participants: 0.37 per 100 person-years (PY; 95% confidence interval [CI] = 0.05/100 PY, 1.33/100 PY); (2) regression of prevalence by years injecting: 0.61 per 100 PY (95% CI = 0.36/100 PY, 0.87/100 PY); (3) stratified extrapolation algorithm: 0.32 per 100 PY (95% CI = 0.18/100 PY, 0.46/100 PY); and (4) newly diagnosed cases of HIV: 0.14 per 100 PY (95% CI = 0.11/100 PY, 0.16/100 PY). CONCLUSIONS: All methods appear to capture the same phenomenon of very low and decreasing HIV transmission among persons who inject drugs. Public Health Implications. If resources are available, the use of multiple methods would provide better information for public health purposes.
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