After 30 years of the HIV epidemic in San Francisco
there is hope that the number of new infections among men who have sex with men
(MSM) is decreasing and that current novel interventions such as treatment as
prevention and pre-exposure prophylaxis will hasten the year that the city sees
the last of new HIV infections. In addition, new HIV cases/incidence is the key
indicator to measure the trajectory of the HIV epidemic. In this analysis we
present an alternate age-cohort approach to estimating HIV incidence and
compare our results to other indicators of incidence.
Data for the present
analysis were collected through National HIV Behavioral Surveillance conducted
among MSM in San Francisco using time location sampling from 2004 to 2014. We
estimated HIV incidence using a model where a closed population of 100 was
divided into number infected and uninfected according to the HIV prevalence of
the 21-25 year group and then estimated what incidence over 30 years
would result in the HIV prevalence at age 50+. Incidence estimates were 7 per 1000
person years (PY) (338 cases), 7 per 1000 PY (312), 6 per 1000 PY (285) and 6
per 1000 PY (271) for 2004, 2008, 2011 and 2014, respectively.
Our data suggest that recent declines in new HIV diagnoses
among MSM in San Francisco maybe due to a reduction in a "back log"
of undiagnosed cases and not as large of a decline in new cases or HIV
incidence. We hypothesize that the decline in new HIV infections among MSM in
San Francisco is much slower than suggested by the decline in new HIV diagnoses.
Purchase full article at: http://goo.gl/Meh4O6
By:
- 1University of California, San Francisco, Epidemiology and Biostatistics, San Francisco, USA. Hfisher.raymond@sfdph.org.
- 2San Francisco Department of Public Health, 25 Van Ness, Suite 500, San Francisco, CA, 94102, USA. Hfisher.raymond@sfdph.org.
- 3San Francisco Department of Public Health, 25 Van Ness, Suite 500, San Francisco, CA, 94102, USA.
- 4University of California, San Francisco, Epidemiology and Biostatistics, San Francisco, USA.
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