       Document 0445
 DOCN  M9640445
 TI    Back-projection and sensitivity analysis of the HIV-AIDS epidemic in the
       Caribbean.
 DT    9604
 AU    Newton EA; Farley JD; Gayle C; Special Program on Sexually Transmitted
       Diseases, Caribbean; Epidemiology Centre (CAREC/PAHO/WHO), Port of
       Spain, Trinidad,; West Indies.
 SO    J Acquir Immune Defic Syndr Hum Retrovirol. 1995 Jan 1;11(1):69-76.
       Unique Identifier : AIDSLINE MED/96130049
 AB    In this study we estimated past human immunodeficiency virus (HIV)
       incidence in 19 nations in the primarily English-speaking Caribbean and
       projected the course of the epidemic to the year 1999. We compared the
       results obtained from several different models of HIV incidence and
       different assumed incubation distributions. Linear and nonlinear
       optimization methods were used to fit several models (power, logistic,
       spline, and step) to adult (age 15 years or older) AIDS incidence data
       derived from our existing surveillance system. All four models tested
       gave good fits to the data, with estimates of cumulative HIV incidence
       in 1993 ranging from 16,504 to 21,732. An increase in the assumed median
       of the AIDS incubation distribution by one year increased the estimates
       of current cumulative adult HIV incidence by approximately 12%; these
       estimates varied by as much as 6% between models. An adjustment of the
       data for possible reporting delay increased the estimates by
       approximately 7% and for underreporting by 25%. Despite their
       sensitivity to underlying assumptions, back-projection estimates provide
       useful insights into the patterns of HIV and AIDS incidence. The models
       indicate that HIV and AIDS incidences in the English-speaking Caribbean
       have been rising steadily, with adult HIV prevalence in the general
       population still less than 1%.
 DE    Acquired Immunodeficiency Syndrome/*EPIDEMIOLOGY  Adult  Caribbean
       Region/EPIDEMIOLOGY  Computer Simulation  Disease Outbreaks/*STATISTICS
       & NUMER DATA  Epidemiologic Methods  Female  Human  HIV
       Infections/*EPIDEMIOLOGY  HIV Seroprevalence/TRENDS  Incidence  Linear
       Models  Male  Prevalence  Support, Non-U.S. Gov't  JOURNAL ARTICLE

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

