ABSTRACT
This article calculates back the HIV seroprevalence in the Netherlands from AIDS cases notified 1982-1990 and rates of progression from HIV to AIDS adopted from American studies. It discusses a number of problems, such as changing AIDS definitions and the possible impact of AZT treatment. We estimate that the Netherlands had approximately 6762 HIV seropositives by the end of 1988, which is considerably lower than earlier expectations. When a hypothetical decrease of 10% in the manifestation of AIDS cases due to AZT treatment was incorporated, the estimate for the end of 1988 becomes 7549. After deduction of the AIDS patients who had died by the beginning of 1989 from this estimate, the HIV seroprevalence by the end of 1988 is approximately 7000. The distribution of seroincidence over time suggests that the HIV epidemic in our country has passed its summit and that the HIV incidence is falling quickly. The question arises as to how far this fortunate development may be considered a success of the Dutch AIDS policy, a policy characterised by more openness than in many other countries. The material studied here, however, allows no definite answer to this intriguing question.
Subject(s)
Acquired Immunodeficiency Syndrome/epidemiology , HIV Seropositivity/epidemiology , Acquired Immunodeficiency Syndrome/drug therapy , Disease Outbreaks/statistics & numerical data , Health Policy , Humans , Models, Theoretical , Netherlands/epidemiology , Population Surveillance/methods , Prevalence , Zidovudine/therapeutic useABSTRACT
In this article we estimate the total number of HIV seropositives in the Netherlands with an extended version of the Fast Back Calculation model. As a result we found between 5500 and 6500 seropositives for the end of 1987. This is considerably lower than earlier expectations. The distribution of incidence over time suggests that the HIV epidemic has passed its summit. We argue that the total number of HIV infected persons halfway 1990 lies somewhere between 7500 and 9000. With the estimated number of HIV seropositives we also predict minimum values for the AIDS incidence in future years. We expect the number of new AIDS cases to increase to over 600 per year in the mid-nineties. We briefly discuss the consequences of our findings for AIDS control. We underline the desirability of a policy directed at risk groups and apart from continuing existing preventive measures aimed at these groups we advocate paying more attention to i.v. drug users, visitors of STD clinics and travellers to and applicants for political asylum from endemic areas.
