Estimating the First 90 of the UNAIDS 90-90-90 Goal: A Review

摘要

Estimating the population with undiagnosed HIV (PUHIV) is the most methodologicallychallenging aspect of evaluating 90-90-90 goals. The objective of this review is todiscuss assumptions, strengths, and shortcomings of currently available methods of thisestimation. Articles from 2000 to 2018 on methods to estimate PUHIV were reviewed.Back-calculation methods including CD4 depletion and test–retest use diagnosis CD4 count,or previous testing history to determine likely infection time thus, providing an estimateof PUHIV for previous years. Biomarker methods use immunoassays to differentiate recentfrom older infections. Statistical techniques treat HIV status as missing data and imputedata for models of infection. Lastly, population surveys using HIV rapid testing mostaccurately calculates the current HIV prevalence. Although multiple methods exist toestimate the number of PUHIV, the appropriate method for future applications depends onmultiple factors, namely data availability and population of interest.