Imperial College London

Jeff Eaton

Faculty of MedicineSchool of Public Health

Senior Lecturer in HIV Epidemiology







Norfolk PlaceSt Mary's Campus






BibTex format

author = {Mahiane, SG and Marsh, K and Glaubius, R and Eaton, JW},
doi = {10.1097/QAD.0000000000002324},
journal = {AIDS},
title = {Estimating and projecting the number of new HIV diagnoses and incidence in Spectrum's case surveillance and vital registration tool.},
url = {},
year = {2019}

RIS format (EndNote, RefMan)

AB - OBJECTIVE: The United Nations Program on HIV/AIDS-supported Spectrum software package is used by most countries worldwide to monitor the HIV epidemic. In Spectrum, HIV incidence trends among adults (aged 15-49 years) are derived by either fitting to seroprevalence surveillance and survey data or generating curves consistent with case surveillance and vital registration data, such as historical trends in the number of newly diagnosed infections or AIDS-related deaths. This article describes development and application of the case surveillance and vital registration (CSAVR) tool for United Nations Program on HIV/AIDS' 2019 estimate round. METHODS: Incidence in CSAVR is either estimated directly using single logistic, double logistic, or spline functions, or indirectly via the 'r-logistic' model, which represents the (log-transformed) per-capita transmission rate using a logistic function. The propensity to get diagnosed is assumed to be monotonic, following a Gamma cumulative distribution function and proportional to mortality as a function of time since infection. Model parameters are estimated from a combination of historical surveillance data on newly reported HIV cases, mean CD4 at HIV diagnosis and estimates of AIDS-related deaths from vital registration systems. Bayesian calibration is used to identify the best fitting incidence trend and uncertainty bounds. RESULTS: We used CSAVR to estimate HIV incidence, number of new diagnoses, mean CD4 at diagnosis and the proportion undiagnosed in 31 European, Latin American, Middle Eastern, and Asian-Pacific countries. The spline model appeared to provide the best fit in most countries (45%), followed by the r-logistic (25%), double logistic (25%), and single logistic models. The proportion of HIV-positive people who knew their status increased from about 0.31 [interquartile range (IQR): 0.10-0.45] in 1990 to about 0.77 (IQR: 0.50-0.89) in 2017. The mean CD4 at diagnosis appeared to be stable, decreasing from 410 cells/&m
AU - Mahiane,SG
AU - Marsh,K
AU - Glaubius,R
AU - Eaton,JW
DO - 10.1097/QAD.0000000000002324
PY - 2019///
SN - 0269-9370
TI - Estimating and projecting the number of new HIV diagnoses and incidence in Spectrum's case surveillance and vital registration tool.
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