       Document 0702
 DOCN  M9640702
 TI    Use of AIDS surveillance data to describe subepidemic dynamics.
 DT    9604
 AU    Cantoni M; Cozzi Lepri A; Grossi P; Pezzotti P; Rezza G; Verdecchia A;
       Laboratory of Epidemiology and Biostatistics, Istituto Superiore; di
       Sanita, Rome, Italy.
 SO    Int J Epidemiol. 1995 Aug;24(4):804-12. Unique Identifier : AIDSLINE
       MED/96022686
 AB    BACKGROUND. Official reports on AIDS surveillance mainly consist of
       absolute numbers of AIDS cases or cumulative incidence rates. More
       detailed analyses focusing on the clusters of subepidemics within Italy
       seemed necessary for a better understanding and more accurate
       description of the epidemic. METHODS. Age-specific AIDS incidence rates
       were calculated with reference to resident population by sex, calendar
       time and geographical area. Age-standardized incidence rates, with the
       Italian resident population in 1990 as standard, were used to present
       time trends and geographical distributions. All analyses were repeated
       for injecting drug users, homosexual/bisexual men, heterosexual contacts
       and individuals with other or undetermined risk factors. RESULTS. Annual
       incidence rates for AIDS in Italy increased over the study period. The
       highest rates were observed in the North and in Sardinia, while Southern
       regions showed generally lower rates. This heterogeneity was more
       evident when examining small geographical areas (i.e. provinces).
       Epidemics in some of the smaller provinces, such as Imperia and Livorno
       (Northwestern port towns), were shown to be important in that they
       greatly affect AIDS incidence rates in the regions in which they are
       located. CONCLUSIONS. According to our analysis, the crude presentation
       of data from the Italian AIDS Registry is not adequate for understanding
       the national spread of the AIDS epidemic in terms of several local
       subepidemics, which may differ by size, temporal trend, and risk group
       composition. Classifying cases according to their place of residence,
       which we considered as a good proxy of the place of life, was
       fundamental for correctly locating these subepidemics. Furthermore, the
       use of age-standardized rates allowed for unbiased comparisons between
       regions whose population may have a different age structure and
       dynamics.
 DE    Acquired Immunodeficiency Syndrome/*EPIDEMIOLOGY/TRANSMISSION  Adult
       Age Distribution  Disease Outbreaks/*STATISTICS & NUMER DATA  Female
       Geography  Human  Incidence  Italy/EPIDEMIOLOGY  Male  Middle Age
       Population Surveillance  Registries  Risk Factors  Sex Behavior
       Substance Abuse, Intravenous/COMPLICATIONS  Support, Non-U.S. Gov't
       Time Factors  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

