HIV Incidence Estimation Methods and Applications
Summary
Accurate estimation of HIV incidence—the rate of new infections in a population—is essential for guiding prevention strategies, allocating resources and evaluating the impact of interventions. Methods for incidence estimation fall broadly into four categories: laboratory recency assays, molecular approaches, mathematical and statistical models, and field-based programme surveillance. Laboratory recency assays employ biomarkers such as antibody avidity, viral load and antigen levels to distinguish recent from longstanding infections in cross-sectional samples. Molecular approaches leverage viral genetic diversity and evolution, using next-generation sequencing to infer time since infection. Mathematical models integrate prevalence and mortality data or serial prevalence surveys to deduce incidence trends over time. Field-based surveillance embeds recency testing algorithms within population surveys or key-population programmes to capture real-time transmission dynamics. Together, these methods inform targeted interventions, identify hotspots of ongoing transmission and allow assessment of programme effectiveness at global, national and local levels.
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HIV Incidence Estimation Methods and Applications publication trend
The graph below shows the total number of articles in hiv incidence estimation methods and applications across all publications each year (not limited to Nature Index journals).
Technical terms
Recent infection testing algorithm (RITA): A protocol combining one or more laboratory assays (such as avidity tests and viral load measurement) to classify HIV infections as recent or long term in cross-sectional samples.
Limiting-antigen avidity assay (LAg-Avidity EIA): A serological test that measures antibody binding strength to a specific HIV antigen, used to identify infections acquired within a defined recent period.
Proviral genetic diversity: Variation in the sequences of HIV DNA integrated into host cells, employed as a molecular proxy for estimating the time elapsed since infection.
Next-generation sequencing (NGS): High-throughput DNA sequencing technology that detects and quantifies genetic variation at high resolution, enabling precise measurement of viral diversity.
References
- Early Release - Risk Factors for Recent HIV Infections among Adults in 14 Countries in Africa Identified by Population-Based HIV Impact Assessment Surveys, 2015–2019 - Volume 29, Number 11—November 2023 - Emerging Infectious Diseases journal - CDC. Emerging Infectious Diseases (2023).
- Genetic Diversity From Proviral DNA as a Proxy for Time Since HIV-1 Infection. The Journal of Infectious Diseases (2024).
- Recent infection testing to inform HIV prevention responses and surveillance in a programme context: lessons from implementation within a nationally scaled female sex worker programme in Zimbabwe. Journal of the International AIDS Society (2024).
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