The effectiveness of interventions on incubation of AIDS as measured by secular increases within a population.
Methods are developed to estimate and test for the impact of intervention use on a population's survival function (time to AIDS). Each participant's history is divided into J + 1 components: omega 0 occurring before the intervention is available and omega 1 to omega J occurring later, as the intervention becomes successively more available. Distribution free truncated Kaplan-Meier models based on time since exposure fit separately to the risk sets/outcomes in omega 0 to omega J directly show the changing patterns of survival. Multivariate proportional hazards models can be used to adjust for covariates. Application of these methods indicates that availability of proven anti-AIDS interventions may have delayed time to AIDS by 8 months in an educated HIV-1 infected homosexual cohort with good access to medical care.
Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD 21205.
D R
DR
Hoover
A
A
Muñoz
Y
Y
He
J M
JM
Taylor
L
L
Kingsley
J S
JS
Chmiel
A
A
Saah
D000163:Acquired Immunodeficiency Syndrome / Q000453:epidemiology / Q000401:mortality / Q000628:therapy*; D017668:Age of Onset; D015331:Cohort Studies; D018450:Disease Progression; D018572:Disease-Free Survival; D015658:HIV Infections / Q000453:epidemiology / Q000401:mortality / Q000628:therapy*; D006679:HIV Seropositivity / Q000453:epidemiology; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D015233:Models, Statistical; D015337:Multicenter Studies as Topic; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D018709:Statistics, Nonparametric; D013997:Time Factors; D016896:Treatment Outcome