We devised a new model for estimating the incidence of HIV infection and the time between infection and diagnosis from HIVsurveillance data. Our approach takes into account temporal changes in HIV test-seeking behaviors and requires few data on individuals newly diagnosed with HIV (i.e. date of diagnosis and clinical status at diagnosis). Using our new approach, we analyzed data for patients newly diagnosed with HIV in France between April 2003 and December 2008.
Results:
The estimated mean time between infection and diagnosis ranged from 37.0 months among men who have sex with men to approximately 53.0 months among heterosexualmen. Intermediate values were obtained for injecting drug users and heterosexualwomen. We estimated that mean times changed very slightly ( 1.2 months) during the period 20042007 it shortened among MSM, remained stable among non-French-national heterosexualmen, and lengthened in all the other exposure categories. We estimated that the total number of new infections increased, but not significantly, between 2004 and 2007, reaching 7851 [95% confidence interval 54009919] in 2007. MSM accounted for the largest number of new infections (38%).
Conclusion:
HIV continues to spread in France, and the average time between infectionand HIVdiagnosis remains excessively long. New policies to expand the offer and acceptance of voluntary HIV testing are thus urgently needed. Our methodwill also be very useful to monitor and evaluate the impact of futureHIV testingpolicies (AU)