Estimation of HIV seroconversion and effects of age in the San Francisco homosexual population

Abstract

Summary Using San Francisco city clinic cohort data, we estimate the HIV seroconversion distribution by both non-parametric and parametric methods, and illustrate the effects of age on this distribution. The non-parametric methods include the Turnbull method, the Bacchetti method, the expectation, maximization and smoothing (EMS) method and the penalized spline method. The seroconversion density curves estimated by these nonparametric methods are of bimodal nature with obvious effects of age. As a result of the bimodal nature of the seroconversion curves, the parametric models considered are mixtures of two distributions taken from the generalized log-logistic distribution with three parameters, the Weibull distribution and the log-normal distribution. In terms of the logarithm of the likelihood values, it appears that the non-parametric methods with smoothing as well as without smoothing (i.e. the Turnbull method) provided much better fits than did the parametric models. Among the non-parametric methods, the EMS and the spline estimates are more appealing, because the unsmoothed Turnbull estimates are very unstable and because the Bacchetti estimates have a longer tail. Among the parametric models, the mixture of a generalized log-logistic distribution with three parameters and a Weibull distribution or a log-normal distribution provided better fits than did other mixtures of parametric models.