International Journal of Epidemiology, Vol 28, 1141-1148, Copyright © 1999 by International Epidemiological Association
H Houweling, LG Wiessing, FF Hamers, F Termorshuizen, ON Gill and MJ Sprenger
BACKGROUND: The long average incubation time from HIV infection to AIDS
makes it difficult to estimate recent HIV transmission from AIDS incidence
data. Age-period-cohort (APC) analysis can separate out the effects of age,
calendar time and birth cohort to provide a clearer picture of transmission
trends. METHODS: AIDS incidence data from 1981 to 1994 among intravenous
drug users (IDU) for 12 Western European countries were used. Yearly
incidences per 100,000 population or 100,000 person-years were calculated
by age at diagnosis and 5-year birth cohort (1950-1954, 1955-1959,
1960-1964, 1965-1969 and 1970- 1974), and corrected for reporting delay.
Incidence patterns were compared between birth cohorts and countries.
RESULTS: For most countries the impact was greatest on the cohort born
1960-1964. Comparing incidence patterns in the 1965-1969 to 1960-1964
cohorts suggest the epidemic has plateaued at low to intermediate levels in
Austria, Greece and the North-Western European countries, and at high
levels in France, Italy and Switzerland. For most countries transmission
amongst the 1970-1974 as compared to the 1965-1969 cohorts could not be
assessed due to small numbers and short follow-up time. In Spain the
epidemic was uncontrolled with a high incidence among recent birth cohorts.
In Portugal the epidemic was still at an early and expanding phase.
CONCLUSIONS: The APC analysis revealed large country differences in the
dynamics of the HIV/AIDS epidemic among IDU. Full interpretation of these
differences is dependent on information from other sources about the local
public health response and trends in drug injecting behaviours. Earlier
introduction of the virus and higher prevalence of injecting drug use may
explain some of the generally higher incidence in Southern European
countries, but the larger part of it is most likely explained by local
characteristics of drug users, such as younger age and more frequent
sharing of needles and syringes, and a less effective public health
response.
An age-period-cohort analysis of 50,875 AIDS cases among injecting drug users in Europe
Department of Infectious Diseases Epidemiology, National Institute of Public Health and the Environment (RIVM), Bilthoven, The Netherlands. hans.houweling@gr.nl
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  P Wu, B J Cowling, C M Schooling, I O L Wong, J M Johnston, C-C Leung, C-M Tam, and G M Leung Age-period-cohort analysis of tuberculosis notifications in Hong Kong from 1961 to 2005 Thorax, April 1, 2008; 63(4): 312 - 316. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 X. Chen, G. Li, J. B. Unger, X. Liu, and C. A. Johnson Secular Trends in Adolescent Never Smoking From 1990 to 1999 in California: An Age-Period-Cohort Analysis Am J Public Health, December 1, 2003; 93(12): 2099 - 2104. [Abstract] [Full Text] [PDF]
|
|