Viral suppression among persons in HIV care in the United States during 2009–2013: Sampling bias in Medical Monitoring Project (MMP) surveillance estimates

Details

• Alternative Title:
  Ann Epidemiol
• Personal Author:
  Bradley, Heather ; Althoff, Keri N. ; Buchacz, Kate ; Brooks, John T. ; Gill, M. John ; Horberg, Michael A. ; Kitahata, Mari M. ; Marconi, Vincent ; Mayer, Kenneth H. ; Mayor, Angel ; Moore, Richard ; Mugavero, Michael ; Napravnik, Sonia ; Paz-Bailey, Gabriela ; Prejean, Joseph ; Rebeiro, Peter F. ; Rentsch, Christopher T. ; Shouse, R. Luke ; Silverberg, Michael ; Sullivan, Patrick S. ; Thorne, Jennifer E. ; Yehia, Baligh ; Rosenberg, Eli S.
• Description:
  Purpose:
  
  To assess sampling bias in national viral suppression (VS) estimates derived from the Medical Monitoring Project (MMP) resulting from use of an abbreviated (four-month) annual sampling period. We aimed to improve VS estimates using cohort data from the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) and a novel cohort-adjustment method.
  
  Methods:
  
  Using full calendar years of NA-ACCORD data, we assessed timing of HIV care attendance (inside versus exclusively outside MMP’s four-month sampling period), VS status at last test (<200 vs. ≥200 copies/mL), and associated demographics. These external estimates were used to standardize MMP to NA-ACCORD data with multivariable regression models of care attendance andVS, yielding adjusted 2009–2013 VS estimates with 95% confidence intervals (CI).
  
  Results:
  
  Weighted percentages of VS among persons in HIV care were 67% in 2009 and 77% in 2013. These estimates are slightly lower than previously published MMP estimates (72% and 80% in 2009 and 2013, respectively). The number of persons receiving HIV care was previously underestimated by 20%, because patients receiving care exclusively outside the MMP sampling period did not contribute toward the weighted population estimate.
  
  Conclusions:
  
  Careful examination of national surveillance estimates using data triangulation and novel methodologies can improve the robustness of VS estimates.
  
  
• Subjects:
  Adult Anti-HIV Agents Cohort Studies Female HIV Infections Humans Male Middle Aged Population Surveillance United States Viral Load

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• Keywords:
  HIV Clinical Care HIV Viral Suppression Indirect Standardization Surveillance
• Source:
  Ann Epidemiol. 31:3-7
• Pubmed ID:
  30529086
• Pubmed Central ID:
  PMC6420358
• Document Type:
  Journal Article
• Funding:
  U01 AI031834/AI/NIAID NIH HHSUnited States/ ; P30 AI094189/AI/NIAID NIH HHSUnited States/ ; U54 MD007587/MD/NIMHD NIH HHSUnited States/ ; U01 AI037613/AI/NIAID NIH HHSUnited States/ ; U01 AA020790/AA/NIAAA NIH HHSUnited States/ ; R01 DA012568/DA/NIDA NIH HHSUnited States/ ; UL1 TR000004/TR/NCATS NIH HHSUnited States/ ; R01 AA016893/AA/NIAAA NIH HHSUnited States/ ; N01 CP001004/CP/NCI NIH HHSUnited States/ ; P30 AI027767/AI/NIAID NIH HHSUnited States/ ; U01 AI035042/AI/NIAID NIH HHSUnited States/ ; P30 AI050409/AI/NIAID NIH HHSUnited States/ ; F31 AI124794/AI/NIAID NIH HHSUnited States/ ; P30 MH062246/MH/NIMH NIH HHSUnited States/ ; U01 AI069434/AI/NIAID NIH HHSUnited States/ ; U01 AI037984/AI/NIAID NIH HHSUnited States/ ; U01 AI103397/AI/NIAID NIH HHSUnited States/ ; R01 DA011602/DA/NIDA NIH HHSUnited States/ ; K23 EY013707/EY/NEI NIH HHSUnited States/ ; TGF-96118/CAPMC/ CIHRCanada/ ; R01 CA165937/CA/NCI NIH HHSUnited States/ ; U01 AI035004/AI/NIAID NIH HHSUnited States/ ; CBR-86906/CAPMC/ CIHRCanada/ ; G12 MD007583/MD/NIMHD NIH HHSUnited States/ ; K24 DA000432/DA/NIDA NIH HHSUnited States/ ; U01 DA036935/DA/NIDA NIH HHSUnited States/ ; R01 HD068395/HD/NICHD NIH HHSUnited States/ ; U01 AI038855/AI/NIAID NIH HHSUnited States/ ; UL1 RR024131/RR/NCRR NIH HHSUnited States/ ; HCP-97105/CAPMC/ CIHRCanada/ ; U01 AI034989/AI/NIAID NIH HHSUnited States/ ; CBR-94036/CAPMC/ CIHRCanada/ ; U01 AI035041/AI/NIAID NIH HHSUnited States/ ; R24 AI067039/AI/NIAID NIH HHSUnited States/ ; UM1 AI035043/AI/NIAID NIH HHSUnited States/ ; U01 AI069432/AI/NIAID NIH HHSUnited States/ ; N02CP55504/CP/NCI NIH HHSUnited States/ ; U01 AI038858/AI/NIAID NIH HHSUnited States/ ; U10 EY008057/EY/NEI NIH HHSUnited States/ ; U01 AI068636/AI/NIAID NIH HHSUnited States/ ; U01 AI034994/AI/NIAID NIH HHSUnited States/ ; M01 RR000052/RR/NCRR NIH HHSUnited States/ ; UL1 TR000454/TR/NCATS NIH HHSUnited States/ ; U10 EY008052/EY/NEI NIH HHSUnited States/ ; UL1 TR002378/TR/NCATS NIH HHSUnited States/ ; P30 AI110527/AI/NIAID NIH HHSUnited States/ ; P30 AI027763/AI/NIAID NIH HHSUnited States/ ; K01 AI093197/AI/NIAID NIH HHSUnited States/ ; U01 AI069918/AI/NIAID NIH HHSUnited States/ ; K24 AI118591/AI/NIAID NIH HHSUnited States/ ; K24 AI065298/AI/NIAID NIH HHSUnited States/ ; U01 AI103401/AI/NIAID NIH HHSUnited States/ ; U38 PS004646/PS/NCHHSTP CDC HHSUnited States/ ; U01 AA013566/AA/NIAAA NIH HHSUnited States/ ; UL1 TR000083/TR/NCATS NIH HHSUnited States/ ; P30 AI027757/AI/NIAID NIH HHSUnited States/ ; KL2 TR000421/TR/NCATS NIH HHSUnited States/ ; U01 AI035040/AI/NIAID NIH HHSUnited States/ ; K01 AI131895/AI/NIAID NIH HHSUnited States/ ; U01 AI103390/AI/NIAID NIH HHSUnited States/ ; U01 AI034993/AI/NIAID NIH HHSUnited States/ ; R24 HD042828/HD/NICHD NIH HHSUnited States/ ; U01 AI103408/AI/NIAID NIH HHSUnited States/ ; U01 AI035039/AI/NIAID NIH HHSUnited States/ ; F31 DA037788/DA/NIDA NIH HHSUnited States/ ; R21 HD075662/HD/NICHD NIH HHSUnited States/ ; R01 AG053100/AG/NIA NIH HHSUnited States/ ; U10 EY008067/EY/NEI NIH HHSUnited States/ ; P30 AI036219/AI/NIAID NIH HHSUnited States/ ; Z01 CP010176/ImNIH/Intramural NIH HHSUnited States/ ; U24 AA020794/AA/NIAAA NIH HHSUnited States/ ; U01 AI068634/AI/NIAID NIH HHSUnited States/ ; P30 AI050410/AI/NIAID NIH HHSUnited States/ ; U01 HD032632/HD/NICHD NIH HHSUnited States/ ; U01 AI042590/AI/NIAID NIH HHSUnited States/
• Volume:
  31
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:22bb7868cf73ef495876e24f35d41d558d82ccada27ca0acd79590de6cae0e5f6b2577e63196f3b860da1be456ff62bddb6d16ebee2ede61a92a01f61fd9473b
• Download URL:
  https://stacks.cdc.gov/view/cdc/76948/cdc_76948_DS1.pdf
• File Type:
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