       Document 0683
 DOCN  M9440683
 TI    HIV incidence among needle exchange participants: estimates from syringe
       tracking and testing data.
 DT    9404
 AU    Kaplan EH; Heimer R; Yale School of Organization and Management, New
       Haven, CT; 06520-8200.
 SO    J Acquir Immune Defic Syndr. 1994 Feb;7(2):182-9. Unique Identifier :
       AIDSLINE MED/94133091
 AB    This paper develops a statistical procedure for estimating the HIV
       infection rate among needle exchange clients without using any
       self-reported information. Instead, data are accumulated by following
       the distribution and return of sequentially labeled syringes and by
       testing a sample of returns for the presence of HIV-1 proviral DNA using
       polymerase chain reaction. For each drug injector in the sample, a
       maximum likelihood change point model is constructed to determine if a
       statistically significant upward shift in the fraction of needles
       testing HIV positive is evident, as would occur if the drug injector in
       question became infected. A second maximum likelihood model is
       formulated to estimate the HIV incidence rate among needle exchange
       participants by aggregating the individual change point results. When
       these methods are applied to the syringe tracking and testing data
       collected to evaluate the legal needle exchange program in New Haven,
       Connecticut, the maximum likelihood incidence estimate equals zero, with
       a 95% confidence interval of 0-10.2 new infections per 100 drug
       injectors per year. Given these data, we cannot reject the null
       hypothesis that no new infections have occurred among needle exchange
       participants between November 1990 and May 1992.
 DE    Connecticut/EPIDEMIOLOGY  Human  HIV Infections/*EPIDEMIOLOGY/PREVENTION
       & CONTROL  Incidence  Likelihood Functions  *Needles  Substance Abuse,
       Intravenous/*COMPLICATIONS  Support, Non-U.S. Gov't  Support, U.S.
       Gov't, P.H.S.  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

