biostudies-literatureGao FNIAID NIH HHSNational Institutes of HealthNIH HHS1446-1461https://www.ebi.ac.uk/biostudies/studies/S-EPMC8918003biostudies-literatureUnknown41(8)Longitudinal cohorts to determine the incidence of HIV infection are logistically challenging, so researchers have sought alternative strategies. Recency test methods use biomarker profiles of HIV-infected subjects in a cross-sectional sample to infer whether they are "recently" infected and to estimate incidence in the population. Two main estimators have been used in practice: one that assumes a recency test is perfectly specific, and another that allows for false-recent results. To date, these commonly used estimators have not been rigorously studied with respect to their assumptions and statistical properties. In this article, we present a theoretical framework with which to understand these estimators and interrogate their assumptions, and perform a simulation study and data analysis Statistics in medicineStatistical considerations for cross-sectional HIV incidence estimation based on recency test.PMC8918003R56 AI143418S10OD028685S10 OD028685Bannick MGao FfalseStatistical considerations for cross-sectional HIV incidence estimation based on recency test.Longitudinal cohorts to determine the incidence of HIV infection are logistically challenging, so researchers have sought alternative strategies. Recency test methods use biomarker profiles of HIV-infected subjects in a cross-sectional sample to infer whether they are "recently" infected and to estimate incidence in the population. Two main estimators have been used in practice: one that assumes a recency test is perfectly specific, and another that allows for false-recent results. To date, these commonly used estimators have not been rigorously studied with respect to their assumptions and statistical properties. In this article, we present a theoretical framework with which to understand these estimators and interrogate their assumptions, and perform a simulation study and data analysis 2022-01-01T00:00:00Z2022 Apr2025-04-21T22:52:23.876Z2025-04-05T19:00:02.835ZS-EPMC89180033498471010.1002/sim.9296