How successful are HIV prevention programs? Which HIV prevention programs are most cost effective? Which programs are worth expanding and which should be abandoned altogether? This book addresses the quantitative evaluation of HIV prevention programs, assessing for the first time several different quantitative methods of evaluation. The authors of the book include behavioral scientists, biologists, economists, epidemiologists, health service researchers, operations researchers, policy makers, and statisticians. They present a wide variety of perspectives on the subject, including an overview of HIV prevention programs in developing countries, economic analyses that address questions of cost effectiveness and resource allocation, case studies such as Israel's ban on Ethiopian blood donors, and descriptions of new methodologies and problems.

The AIDS epidemic has spread worldwide, and nearly 300,000 cases have been reported in the United States alone. Statisticians and epidemiologists are called upon to design and correctly interpret studies on the prevention and control of disease caused by the human immunodeficiency virus (HIV) and to estimate the magnitude and future course of the epidemic. In addition to a comprehensive discussion of methods for gauging the extent of the epidemic and forecasting AIDS incidence, this book presents methods and results concerning the risks of HIV transmission, the incubation period of HIV infection, markers of disease progression, prevention strategies, including strategies to protect the blood supply, and the evaluation of treatments and vaccines. These topics are presented quantitatively, with an emphasis on the strengths and weaknesses of available data. The book highlights how a naive statistical approach to the design or analysis of such studies can lead to seriously misleading results. The various methods of monitoring and forecasting HIV disease and AIDS incidence are given thorough treatment. These methods include back-calculation, which the authors developed; interpretations of survey data on HIV prevalence and incidence; mathematical models for HIV transmission; and approaches that combine different types of epidemiological data. Much of the material in this book - such as a discussion of methods for assessing safety of the blood supply. an evaluation of survey approaches and methods to project pediatric AIDS incidence - has not been previously published.

Public health faces critical challenges ranging from outbreaks of new and old pathogens to the threat of bioterrorism and the impact of lifestyle and envrionmental changes on health. Modern tools of health surveillance and sound statistical practices are essential for meeting these challenges and providing accurate warnings about real public health threats without wasting resources on false alarms. Advances in statistical techniques, computing power and the Internet have led to many new approaches to monitoring population health, analyzing the data, and rapidly sharing it. This text explores the critical issues in the statistical analysis and interpretation of public health surveillance data. It covers statistical methods for detecting disease outbreaks and clusters, the use of survey methods, interpreting time trends and geographic patterns, exploratory statistical analysis of surveillance data, and web-based health reporting systems for the rapid detection of public health problems, among other topics. The methodological approaches are illustrated in discussions of several current public health issues, including the HIV/AIDS epidemic, anthrax, health effects of particulate air pollution, and trends in prostate cancer. The methods are broadly applicable to surveillance systems and registries for numerous health conditions, e.g. infectious diseases, chronic diseases, adverse drug reactions. The book provides numerous illustrations, worked examples, and practical information for actually implementing the methods. It will serve as a reference for public health practitioners and as a textbook for courses on disease surveillance taken by students of statistics biostatistics, epidemiology or public health.