2015 APHA Annual Meeting & Expo

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Online Program

325604
Getting Close to Zero New HIV Infections: Consistency in Multiple Methods for Measuring Low HIV Incidence among People Who Inject Drugs in New York City,


Monday, November 2, 2015

Don C. Des Jarlais, PhD, The Baron Edmond de Rothschild Chemical Dependency Institute, Icahn School of Medicine at Mount Sinai, New York, NY
Kamyar Arasteh, PhD, The Baron Edmond de Rothschild Chemical Dependency Institute, Icahn School of Medicine at Mount Sinai, New York, NY
Courtney McKnight, DrPH, The Baron Edmond de Rothschild Chemical Dependency Institute, Icahn School of Medicine at Mount Sinai, New York, NY
Jonathan Feelemyer, MS, The Baron Edmond de Rothschild Chemical Dependency Institute, Icahn School of Medicine at Mount Sinai, New York, NY
Aimee Campbell, PHD, Department of Psychiatry, Columbia University, New York, NY
Susan Tross, PHD, Department of Psychiatry, Columbia University, New York, NY
Hannah LF Cooper, ScD, SM, Department of Behavioral Sciences and Health Education, Rollins School of Public Health at Emory University, Atlanta, GA
Holly Hagan, PhD, Center for Drug Use and HIV Research, New York, NY
David C. Perlman, MD, Department of Medicine, Mount Sinai Beth Israel, New York, NY
  
Objectives: Reliable measures of HIV incidence are critical for evaluation of community-level “combined prevention,” including “treatment as prevention” (TasP), but low HIV incidence is particularly difficult to measure. We compared methods for estimating HIV incidence among persons who inject drugs (PWID) in New York City (NYC) from 2005-2014.

Methods: Four methods were used to estimate HIV incidence: (1) HIV seroconversions among repeat PWID participants in a long-running research study, (2) The slope of the curve of HIV prevalence by years injecting for new injectors in the same study, (3) Incident cases of HIV among PWID and  PWID men who have sex with men  in New York State (NYS) using the NYS Department of Health (DOH)/Centers for Disease Control (CDC) serologic incidence algorithm, and (4) Newly identified HIV cases among PWID in HIV Surveillance reports from the NYC Department of Health and Mental Hygiene (DOHMH).

Results: There was great consistency among the estimated incidence measures: (1) 0.37/100 person-years (PY) using repeat participants, (2) 0.58/100 PY using slope of prevalence by years injecting for new injectors, (3) 0.32/100 PY using NYSDOH/CDC serologic algorithm, and (4) 0.13 PY using newly identified cases of HIV reported to NYCDOHMH.  The estimated HIV incidence range was 0.5/100 PY (0.2/100 PY after 2010).

Conclusions: The consistency across different estimates suggests that all are capturing the same phenomenon of low/decreasing HIV transmission among PWID in NYC. The HIV epidemic among PWID in NYC appears to be reaching an endemic state with close to zero new infections.

Learning Areas:

Biostatistics, economics
Epidemiology
Public health or related research

Learning Objectives:
Explain how different methods for measuring HIV incidence can lead to different estimates depending on data source Compare and evaluate consistency in different methods to measuring HIV incidence among persons who inject drugs

Keyword(s): HIV/AIDS, Drug Abuse

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Dr. Des Jarlais is a leader in the fields of AIDS and injecting drug use, and has published extensively on these topics. He is active in international research, having collaborated on studies in many different countries. He serves as consultant to various institutions, including the CDC, NIDA, the National Academy of Sciences, and WHO.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 3364.0: HIV and Substance Use