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New public health policy impact case study on estimating the HIV burden

last modified Jun 12, 2017 04:01 PM
Read the latest case study from the Public Health: research into policy project

Devising and applying statistical methods to underpin national HIV policy


Human immunodeficiency virus (HIV) has been a serious public health concern in the UK, and continues to be one of the biggest epidemics of our time. It is estimated that in 2014, over 100,000 people living in the UK had HIV, and that 36.7 million individuals were living with HIV globally in 2015. The disease, which attacks the body’s immune system and compromises its ability to combat infections and diseases, is associated with serious morbidity, and high costs of treatment and care. Though there is no cure, early diagnosis and treatment can prevent HIV from moving into the advanced stage (acquired immune deficiency syndrome [AIDS]), in which the body is unable to fight off life-threatening infections.


Robust monitoring of the disease burden is crucial in order to effectively plan care provision and the implementation and evaluation of public health policies, which seek to reduce the transmission of the disease. The disease burden includes the proportion (prevalence) of individuals living with HIV, and the number of infections remaining undiagnosed, in both the general population, and within specific groups at high risk of infection. Quantifying the size of the infected and undiagnosed portion of the epidemic is particularly important as undiagnosed individuals cannot benefit from the highly effective treatments available and they can unknowingly spread the disease, which will impact the need for HIV services.


Dr De Angelis and her team at the Medical Research Council’s (MRC) Biostatistics Unit (BSU) provide much needed estimates on the HIV burden. Their novel Multi-Parameter Evidence Synthesis (MPES) approach to estimating the HIV burden has been, and continues to be, the chosen method to obtain UK official annual HIV prevalence estimates. For over a decade BSU has worked with Public Health England (PHE) to provide evidence for the annual reports on the state of the HIV epidemic in the UK.


The philosophy underlying the MPES approach is that estimation of epidemiological quantities of interest on which direct information is unavailable or inadequate, such as the HIV burden, can be informed by the combination of disparate and imperfect sources of evidence. Data are combined through a statistical model that exploits data fully, typically leading to more precise and less biased estimates than approaches that rely on selected “best quality” information.


To read the case study in full, click here.

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