Introduction: We aimed to evaluate the impact of highly active antiretroviral therapy (HAART) on AIDS mortality, taking into account earlier HIV incidence patterns.
Methods: Using AIDS Surveillance data (1982-2000), we calculated the observed course of the AIDS epidemic among homosexual men in Amsterdam, The Netherlands. We used the HIV incidence patterns (1980-2000) among homosexual men participating in the hepatitis B vaccine trial and the Amsterdam Cohort Study and those attending the Amsterdam sexual transmitted infections clinic, together with the time from seroconversion to AIDS and death in the pre-HAART era, to estimate the natural course of the AIDS epidemic if HAART had not been introduced.