| Titre : | Differences among U.S. states in estimating the number of people living with HIV/AIDS : Impact on allocation of federal ryan white funding. (2007) |
| Auteurs : | Denis NASH ; Evie ANDREOPOULOS ; Deborah HOROWITZ ; SOHLER (Nancy) : USA. City College Medical School. City University of New York. New York. NY. ; David Vlahov ; Center for Urban Epidemiologic Studies. The New York Academy of Medicine. New York. NY. USA ; International Center for Aids Care and Treatment Programs. Mailman School of Public Health. Columbia University. New York. NY. USA |
| Type de document : | Article |
| Dans : | Public health reports (vol. 122, n° 5, 2007) |
| Pagination : | 644-656 |
| Langues: | Anglais |
| Mots-clés : | Estimation ; Sida ; Politique santé ; Gouvernement ; Financement ; Virose ; Infection ; Immunopathologie |
| Résumé : | [BDSP. Notice produite par INIST-CNRS qOc3oR0x. Diffusion soumise à autorisation]. Objective. We assessed the impact of differing laboratory reporting scenarios on the completeness of estimates of people living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) (PLWHA) in the U.S., which are used to guide allocation of federal Ryan White funds. Methods. We conducted a four-year simulation study using clinical and laboratory data on 1,337 HIV-positive women, including 477 (36%) who did not have AIDS at baseline. We estimated the completeness of HIV (non-AIDS) case ascertainment for three laboratory reporting scenarios : CD4<200 cells/muL and detectable viral load (Scenario A) ; CD4<500 cells/muL and no viral load reporting (Scenario B) ; and CD4<500 cells/muL and detectable viral load (Scenario C). Results. Each scenario resulted in an increasing proportion of HIV (non-AIDS) cases being ascertained over time, with Scenario C yielding the highest by Year 4 (Year 1 : 69.0%, Year 4 : 88.1%), followed by Scenario A (Year 1 : 63.3%, Year 4 : 84.5%), and Scenario B (Year 1 : 43.0%, Year 4 : 67.7%). Overall completeness of PLWHA ascertainment after four years was highest for Scenario C (95.8%), followed by Scenario A (94.5%), and Scenario B (88.5%). Conclusions. Differences in laboratory reporting regulations lead to substantial variations in the completeness of PLWHA estimates, and may penalize jurisdictions that are most successful at treating HIV/AIDS patients or those with weak or incomplete HIV/AIDS surveillance systems. |
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