Estimates of HIV incidence from household-based prevalence surveys

Objective: To estimate HIV incidence in the general population in countries where there have been two recent household-based HIV prevalence Surveys (the Dominican Republic, Mali, Niger, Tanzania, and Zambia). Methods: We applied a validated method to estimate HIV incidence using HIV prevalence measurement in two surveys. Results: We estimate incidence among men and women aged 15-44 years to be: 0.5/1000 person-years at risk in the Dominican Republic 2002-2007, 1.1/1000 in Mali 2001-2006, 0.6/1000 in Niger 2002-2006, 3.4/1000 in Tanzania 2004-2008, and 11.2/1000 in Zambia 2002-2007. The groups most at risk in these epidemics are typically 15-24-year-old women and 25-39-year-old men. Incidence appears to have declined in recent years in all Countries, but only significantly among men in the Dominican Republic and Tanzania and women in Zambia. Conclusion: Using prevalence measurements to estimate incidence reveals the Current level and age distribution of new infections and the trajectory of the HIV epidemic. This information is more useful than prevalence data alone and should be used to held determine priorities for interventions. (C) 2010 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins