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Viral suppression among persons in HIV care in the United States during 2009–2013: Sampling bias in Medical Monitoring Project (MMP) surveillance estimates
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3 2019
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Source: Ann Epidemiol. 31:3-7
[PDF-75.73 KB]
Details:
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Alternative Title:Ann Epidemiol
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Personal Author:
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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.
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Pubmed ID:30529086
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Pubmed Central ID:PMC6420358
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Volume:31
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