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Estimating HIV-1 incidence using biomarker assays in cross-sectional surveysis important for understanding the HIV pandemic. However, the utility of theseestimates has been limited by uncertainty about what input parameters to usefor False Recency Rate (FRR) and Mean Duration of Recent Infection (MDRI) afterapplying recent infection testing algorithm (RITA). This article shows howtesting and diagnosis in a population reduce both FRR and MDRI compared to atreatment-naive population. Using self-reported testing history, a new methodis proposed for calculating appropriate context-specific estimates of FRR andMDRI. The result of this is a new formula for incidence that depends only onreference FRR and MDRI parameters derived in an undiagnosed, treatment-naive,non-elite controller, non-AIDS-progressed population.

Improving Biomarker Based HIV Incidence Estimation in the Treatment Era