Nov 15, 2019

EPP-ASM and the r-hybrid model: new tools for estimating HIV incidence trends in sub-Saharan Africa

AIDS
Jeffrey W EatonTimothy B Hallett

Abstract

Improve models for estimating HIV epidemic trends in sub-Saharan Africa (SSA). Mathematical epidemic model fit to national HIV survey and ANC sentinel surveillance (ANC-SS) data. We modified EPP to incorporate age and sex stratification (EPP-ASM) to more accurately capture the shifting demographics of maturing HIV epidemics. Secondly, we developed a new functional form, termed 'r-hybrid', for the HIV transmission rate which combines a four-parameter logistic function for the initial epidemic growth, peak, and decline followed by a first-order random walk for recent trends after epidemic stabilization. We fitted the r-hybrid model along with previously developed r-spline and r-trend models to HIV prevalence data from household surveys and ANC-SS in 177 regions in 34 SSA countries. We used leave-one-out cross validation with household survey HIV prevalence to compare model predictions. The r-hybrid and r-spline models typically provided similar HIV prevalence trends, but sometimes qualitatively different assessments of recent incidence trends due to different structural assumptions about the HIV transmission rate. The r-hybrid model had the lowest average continuous ranked probability score, indicating the best model predictions....Continue Reading

Mentioned in this Paper

Erythropoietic Protoporphyria
Ritonavir
Stratification
Sentinel Node (Disorder)
Acid sphingomyelinase
Cross Validation
HIV Infections
Evaluation
Disease Transmission
Structure

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