HIV Incidence in Rural South Africa: Comparing Estimates from Different Testing Methods
Author Information
Author(s): Bärnighausen Till, Wallrauch Claudia, Welte Alex, McWalter Thomas A., Mbizana Nhlanhla, Viljoen Johannes, Graham Natalie, Tanser Frank, Puren Adrian, Newell Marie-Louise
Primary Institution: Africa Centre for Health & Population Studies, University of KwaZulu-Natal, Durban, South Africa
Hypothesis
The cBED assay overestimates HIV incidence due to false classifications of non-recent infections as recent.
Conclusion
The cBED assay provides accurate HIV incidence estimates when using a locally measured long-term false-positive ratio.
Supporting Evidence
- The long-term false-positive ratio of the cBED assay was found to be 0.0169.
- HIV incidence estimates using the cBED assay varied significantly based on the false-positive ratio used.
- Longitudinally measured HIV incidence was 3.09 per 100 people per year.
Takeaway
This study looked at how well a test for recent HIV infections works in a rural area of South Africa, finding that it can give good estimates if adjusted correctly.
Methodology
The study used longitudinal HIV surveillance data and cBED assay testing to compare HIV incidence estimates.
Potential Biases
Potential bias due to misclassification of HIV status in individuals with non-recent infections.
Limitations
The study's sample may not represent all demographics, and the statistical power for subgroup analyses was limited.
Participant Demographics
Participants were predominantly Zulu-speaking individuals from a rural community in KwaZulu-Natal, South Africa.
Statistical Information
P-Value
0.0001
Confidence Interval
95% CI 0.0100–0.0266
Statistical Significance
p<0.0001
Digital Object Identifier (DOI)
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