Comparison of HIV Prevalence Among Antenatal Clinic Attendees Estimated from Routine Testing and Unlinked Anonymous Test
- PDF / 1,348,775 Bytes
- 16 Pages / 439.37 x 666.142 pts Page_size
- 50 Downloads / 182 Views
Comparison of HIV Prevalence Among Antenatal Clinic Attendees Estimated from Routine Testing and Unlinked Anonymous Testing Ben Sheng1 · Jeffrey W. Eaton2 · Mary Mahy3 · Le Bao1 Received: 11 March 2019 / Revised: 6 October 2019 / Accepted: 8 January 2020 © International Chinese Statistical Association 2020
Abstract 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 ANC-RT in 15 countries that had both data sources in overlapping years. We used linear mixed-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. Keywords Antenatal clinic · HIV prevalence · Unlinked anonymous HIV testing · Routine HIV testing · Calibration parameter · Linear mixed-effects model
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s1256 1-020-09265-4) contains supplementary material, which is available to authorized users. * Le Bao [email protected] Extended author information available on the last page of the article
13
Vol.:(0123456789)
Statistics in Biosciences
1 Introduction Monitoring trends in HIV prevalence is the cornerstone of HIV surveillance. Monitoring prevalence allows countries to estimate incidence trends and track progress toward reducing new HIV infections and ending the AIDS epidemic. To monitor trends in HIV prevalence, nearly all high HIV prevalence countries established HIV sentinel surveillance surveys at antenatal clinics (ANCs) in the early 1990s, and repeated those surveys every 1 or 2 years. HIV prevalence data were collected from sentinel ANC sites chosen to provide a large enough sample size to monitor trends over time. The surveillance was based on unlinked anonymous testing (UAT) of women attending these selected ANCs [17]. In recent years, many countries have transitioned from conducting UAT sentinel surveillance surveys in favor of more efficient use of the routine testing (RT) done at ANCs [8], and the data in the Spectrum file
Data Loading...
