       Document 0386
 DOCN  M9650386
 TI    How many HIV infections are there in Israel? Reconstructing HIV
       incidence from AIDS case reporting.
 DT    9605
 AU    Kaplan EH; Slater PE; Soskolne V; Hebrew University-Hadassah Braun
       School of Public Health and; Community Medicine, Jerusalem, Israel.
 SO    Public Health Rev. 1995;23(3):215-35. Unique Identifier : AIDSLINE
       MED/96137686
 AB    BACKGROUND: The reporting of AIDS cases to Israel's Ministry of Health
       is believed to be accurate, but the completeness of HIV surveillance is
       unknown. We implement a model that reconstructs HIV incidence in Israel
       from AIDS case reports excluding Ethiopian immigrants. METHODS: We apply
       the well-known method of backcalculation to AIDS cases reported to the
       Ministry of Health. The data are adjusted statistically to account for
       reporting delays and the elimination of AIDS Related Complex reporting.
       The analysis also accounts for the impact of differential administration
       of antiretroviral therapy to HIV-infected persons over time. RESULTS:
       Excluding Ethiopian immigrants, we find that the cumulative number of
       HIV infections reported to the Ministry of Health through December 1993
       (1,011) is not statistically different from the model's estimate of 922
       (z = 1.04; p = 0.30), though the reported number of new infections in
       recent years exceeds the modeleted rate. CONCLUSIONS: The low HIV
       incidence estimated among non-Ethiopian Israelis is consistent with
       other studies of sexually transmitted diseases and HIV-related risky
       behavior in Israel. This result counters the hypothesis that an
       explosive HIV epidemic will occur. That the number of recently reported
       new infections exceeds the estimate from the model could indicate that
       the reporting system is catching up with the extant spread of disease,
       or that the model is missing some aspect of the dynamics of HIV in
       Israel. We suggest that comparing future annual HIV incidence rates to
       the model's upper bound of 80 infections per year will enable resolution
       of this issue over time.
 DE    Acquired Immunodeficiency Syndrome/EPIDEMIOLOGY  Disease Notification
       Ethiopia/ETHNOLOGY  Forecasting  Human  HIV Infections/*EPIDEMIOLOGY
       Incidence  Israel/EPIDEMIOLOGY  Models, Statistical  Support, Non-U.S.
       Gov't  JOURNAL ARTICLE

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

