Back-calculation and projection of the HIV/AIDS epidemic among homosexual/ bisexual men in three European countries: evalution of past projections and updates allowing for treatment effects.
This study critically evaluates the quality of 1990 back-calculations and long-term projections of the HIV/AIDS epidemic for homosexual/bisexual men in France, the Federal Republic of Germany, and the UK. The projection captured the general pattern observed in all three countries although the observed AIDS incidence peaked 2-3 years later and declined faster than had been projected. Total AIDS incidences from 1989 to 2000 were overestimated by 38.5% in France, and underestimated by 23.9 and 17.5% in western Germany and the UK. Updated back-calculations and projections to 2020 use AIDS incidence data up to 2000. The procedure incorporates an asymmetric long-tailed cumulative HIV curve as well as the increase in the median incubation period brought about by new therapies introduced during the 1990s. The results suggest that: (i) The rapid decrease in cases during the late 1990s was caused by a median incubation period that increased from 10 years to 21-23 years by the late 1990s. (ii) An imminent bottoming out followed by a protracted increase in AIDS cases from 2000 to at least 2010 could be the consequence of a leveling off of the median incubation period. (iii) A low variant of the projections shows that at least 40,000 homosexual men could develop AIDS in the three countries after 2000.
Artzrouni
Marc
M
Department of Applied Mathematics, University of Pau, BP 1133, Pau, France. marc.artzrouni@univ-pau.fr
D000163:Acquired Immunodeficiency Syndrome / Q000175:diagnosis / Q000453:epidemiology*; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods*; D001727:Bisexuality; D004196:Disease Outbreaks; D005260:Female; D005602:France / Q000453:epidemiology; D005858:Germany / Q000453:epidemiology; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D006716:Homosexuality; D006801:Humans; D008297:Male; D015233:Models, Statistical; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D016019:Survival Analysis; D016896:Treatment Outcome; D006113:United Kingdom / Q000453:epidemiology