Evaluation of Undiagnosed HIV Estimates Computed from the CD4 Depletion Model in a Rural, Medium–low HIV Prevalence State
| Autor: | V. T. Nguyen, J. L. Meier, A. Jatta, R. Mayer |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
High prevalence Social Psychology business.industry Public health Public Health Environmental and Occupational Health Human immunodeficiency virus (HIV) medicine.disease_cause Hiv prevalence law.invention Infectious Diseases Transmission (mechanics) law medicine Medical diagnosis business Demography |
| Zdroj: | AIDS and Behavior. 26:613-622 |
| ISSN: | 1573-3254 1090-7165 |
| DOI: | 10.1007/s10461-021-03419-1 |
| Popis: | The CD4 depletion model estimates diagnosis delays by approximating infection date from CD4 T-cell count at diagnosis, and back-calculation can compute the proportion of undiagnosed PLWHA. The model assumes the immigration of PLWHA to the U.S. is negligible and counts as a transmission event, which may be impractical outside high prevalence states. Duration of U.S. residency among foreign-born PLWHA and diagnosis delays were compared. The impact on estimates of undiagnosed PLWHA was tested through simulation with different proportions of foreign-born people assumed to have acquired HIV abroad. In 67% of foreign-born people, the mean (SD) years of delay (9.9 (6.3)) exceeded the duration of U.S. residency (2.0 (1.9)). Additionally, inaccuracies in the estimates for proportions of undiagnosed PLWHA were pronounced when foreign-born people who acquired HIV abroad comprised 30% of diagnoses. The CD4 model inadvertently misclassified some diagnoses as in-state transmission events. Consequently, simulated results demonstrated inaccuracies and unstable calculations. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink