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September 5, 1990

AIDS Projections: How Farr Out?-Reply

JAMA. 1990;264(9):1104. doi:10.1001/jama.1990.03450090039018

In Reply.—  We appreciate Mr Artzrouni calling our attention to his research presented at the Fourth International Conference on AIDS, where he stated: "Under the model's assumptions the AIDS epidemic curve will reach its maximum in the early 1990s." We therefore amend the sentence in our article to the following: "Only one of 13 models in the GAO [General Accounting Office] report considered the concept that the epidemic might crest then decline." We welcome Mr Artzrouni into the small but growing group of epidemiologists who believe the epidemic curve in the United States has or soon will crest and then progressively decline toward a still-to-be-determined low endemic level.To our knowledge, AIDS is the first epidemic whose trends are repeatedly graphed in terms of cumulative incidence. We believe this method of presenting epidemiologic trends confuses many people because cumulative incidence always increases with the passage of time. The General