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Measuring HIV incidence is critical to monitoring and, in the long run, controlling HIV infection in populations at risk worldwide. The serologic testing algorithm for recent HIV seroconversion (STARHS) assay allows one, under the right conditions, to determine HIV incidence from a single specimen. This approach is both elegant and exciting, since it can yield estimates of incidence in many situations where cohort studies are not feasible. Longitudinal cohort studies follow initially uninfected persons over time but are expensive, time-consuming and subject to biases related to selective recruitment and attrition as well as intervention effect which make their interpretation problematic. White and colleagues have recently published two reports in Sexually Transmitted Infections which examine an important issue in the application of STARHS.1 2
To help realise the enormous potential of such an approach, the WHO formed an international working group following a special session of the International AIDS Conference in Toronto in 2006. This WHO Working Group on HIV Incidence Assays recently published a comprehensive review of the progress made in the last 10 years and the substantial challenges remaining.3 In addition, UNAIDS recently launched the High Commission on HIV Prevention to reinvigorate HIV prevention worldwide; the Commission has already expressed a strong interest in promoting and exploiting improvements in …
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