Is Back-Projection Methodology Still Relevant for Estimating HIV Incidence from National Surveillance Data?

Kylie-Ann Mallitt, David P Wilson* , Ann McDonald, Handan Wand
The Kirby Institute, University of New South Wales, Sydney, Australia

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© Mallitt et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Kirby Institute, University of New South Wales, Sydney, Australia; Tel: +61 2 9385 0959; Fax: +61 2 9385 0920; E-mail:


Accurate estimates of HIV incidence are crucial to understand the extent of transmission of the infection, evaluate intervention strategies and effectively plan new public health control measures. HIV/AIDS surveillance systems in numerous industrialised countries record the number of known new HIV and/or AIDS diagnoses, which are often used as a surrogate marker for HIV incidence. HIV/AIDS diagnosis data have been used to reconstruct historical HIV incidence trends using modified back-projection methods. Estimates of HIV incidence are most robust when reliable data on the number of incident infections, a subset of all diagnoses, is widely available, and surveillance systems should prioritise the collection of these data. Back-projection alone provides reliable estimates of HIV incidence in the past, but is not useful when estimating current or future HIV incidence. However, back-projection methodology should be used in conjunction with other corroborative methods to estimate current HIV incidence, and methods to combine the various techniques should be investigated.

Keywords: AIDS, back-calculation, undiagnosed HIV, HIV testing..