Problems in interpreting HIV sentinel seroprevalence studies

Howard Strickler, Donald R. Hoover, Rebecca Dersimonian

Research output: Contribution to journalArticle

20 Scopus citations

Abstract

Estimating human immunodeficiency virus (HIV) prevalence from sentinel seroprevalence studies is difficult. We characterize these studies and show that most are investigations of incompletely defined (hypothetical) cohorts and are usually based on nonprobability samples. Prevalence in HIV sentinel serosurveys is also time-averaged and vulnerable to several time-dependent sources of bias (e.g., migration, deaths, and changes in incidence). Assumptions must be made that these time-dependent biases did not meaningfully affect the data, and this can be helped by reducing the period of investigation. Furthermore, we show that "reliability" can not be adequately measured by standard error, that "internal validity" is vulnerable to self-selection bias and laboratory problems, and that "generalizability" is limited. We propose that what is needed is a procedure (like formal metaanalysis methods) incorporating information from several separate HIV sentinel seroprevalence studies, in a manner that is reproducible and can take into consideration the differences between studies.

Original languageEnglish (US)
Pages (from-to)447-454
Number of pages8
JournalAnnals of Epidemiology
Volume5
Issue number6
DOIs
StatePublished - Nov 1995
Externally publishedYes

Keywords

  • Acquired immunodeficiency syndrome
  • epidemiology
  • human immunodeficiency virus type 1
  • seroprevalence
  • survey methods

ASJC Scopus subject areas

  • Epidemiology

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