Getting Close to Zero New HIV Infections: Consistency in Multiple Methods for Measuring Low HIV Incidence among People Who Inject Drugs in New York City,
Methods: Four methods were used to estimate HIV incidence: (1) HIV seroconversions among repeat PWID participants in a long-running research study, (2) The slope of the curve of HIV prevalence by years injecting for new injectors in the same study, (3) Incident cases of HIV among PWID and PWID men who have sex with men in New York State (NYS) using the NYS Department of Health (DOH)/Centers for Disease Control (CDC) serologic incidence algorithm, and (4) Newly identified HIV cases among PWID in HIV Surveillance reports from the NYC Department of Health and Mental Hygiene (DOHMH).
Results: There was great consistency among the estimated incidence measures: (1) 0.37/100 person-years (PY) using repeat participants, (2) 0.58/100 PY using slope of prevalence by years injecting for new injectors, (3) 0.32/100 PY using NYSDOH/CDC serologic algorithm, and (4) 0.13 PY using newly identified cases of HIV reported to NYCDOHMH. The estimated HIV incidence range was 0.5/100 PY (0.2/100 PY after 2010).
Conclusions: The consistency across different estimates suggests that all are capturing the same phenomenon of low/decreasing HIV transmission among PWID in NYC. The HIV epidemic among PWID in NYC appears to be reaching an endemic state with close to zero new infections.
Learning Areas:Biostatistics, economics
Public health or related research
Explain how different methods for measuring HIV incidence can lead to different estimates depending on data source Compare and evaluate consistency in different methods to measuring HIV incidence among persons who inject drugs
Keyword(s): HIV/AIDS, Drug Abuse
Qualified on the content I am responsible for because: Dr. Des Jarlais is a leader in the fields of AIDS and injecting drug use, and has published extensively on these topics. He is active in international research, having collaborated on studies in many different countries. He serves as consultant to various institutions, including the CDC, NIDA, the National Academy of Sciences, and WHO.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.