Distinguishing sources of HIV transmission from the distribution of newly acquired HIV infections: why is it important for HIV prevention planning?

Mishra, Sharmistha; Pickles, Michael; Blanchard, James; Moses, Stephen; Boily, Marie‐Claude

doi:10.1136/sextrans-2013-051250

Cited by 31 publications

(46 citation statements)

References 21 publications

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“…It also captures the influence of FSW cross-border migration in a setting where the majority of FSW are not local nationals. The combination of good data and dynamical modelling has allowed a better appreciation of the contribution of sex work to overall HIV transmission than when relying on classical methods to estimate PAF [33]–[35].…”

Section: Discussionmentioning

confidence: 99%

Positive Impact of Increases in Condom Use among Female Sex Workers and Clients in a Medium HIV Prevalence Epidemic: Modelling Results from Project SIDA1/2/3 in Cotonou, Benin

et al. 2014

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BackgroundA comprehensive, HIV prevention programme (Projet Sida1/2/3) was implemented among female sex workers (FSWs) in Cotonou, Benin, in 1993 following which condom use among FSWs increased threefold between 1993 and 2008 while FSW HIV prevalence declined from 53.3% to 30.4%.ObjectiveEstimate the potential impact of the intervention on HIV prevalence/incidence in FSWs, clients and the general population in Cotonou, Benin.Methods and FindingsA transmission dynamics model parameterised with setting-specific bio-behavioural data was used within a Bayesian framework to fit the model and simulate HIV transmission in the high and low-risk population of Cotonou and to estimate HIV incidence and infections averted by SIDA1/2/3. Our model results suggest that prior to SIDA1/2/3 commercial sex had contributed directly or indirectly to 93% (84–98%) of all cumulative infections and that the observed decline in FSWs HIV prevalence was more consistent with the self-reported post-intervention increase in condom use by FSWs than a counterfactual assuming no change in condom use after 1993 (CF-1). Compared to the counterfactual (CF-1), the increase in condom use may have prevented 62% (52–71%) of new HIV infections among FSWs between 1993 and 2008 and 33% (20–46%) in the overall population.ConclusionsOur analysis provides plausible evidence that the post-intervention increase in condom use during commercial sex significantly reduced HIV prevalence and incidence among FSWs and general population. Sex worker interventions can be effective even in medium HIV prevalence epidemics and need to be sustained over the long-term.

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Section: Discussionmentioning

confidence: 99%

Positive Impact of Increases in Condom Use among Female Sex Workers and Clients in a Medium HIV Prevalence Epidemic: Modelling Results from Project SIDA1/2/3 in Cotonou, Benin

et al. 2014

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“…With a national HIV prevalence of 3.7% in 2012 15 , the lessons learned from an in-depth review and comprehensive analysis of the past national response in Côte d'Ivoire would improve the evidence base for existing and future health policies. Further, recent studies have also shown the importance of understanding which subgroups of susceptible individuals are more likely to acquire new infections (i.e., the source of HIV acquisitions) and which groups of HIV positive individuals are more likely to transmit infections (i.e., the source of HIV transmissions) in the long-term using transmission dynamic models 16-18 . The source of HIV transmission, also called the transmission Population Attributable Fraction (PAF) 19 , incorporates not only information on infections from index cases to their partners but also from such secondary infected partners to their partners (i.e., chains of transmission).…”

Section: Introductionmentioning

confidence: 99%

“…The transmission PAF metric is more useful than the source of acquisitions to identify epidemic drivers - defined as the group with a risk factor that accounts for most of HIV transmission and for which transmission could be most efficiently prevented if it was blocked. As such, dynamic models of HIV transmission, such has the one used in this study, provide more useful information to inform HIV prevention programs than static model such as the Modes of Transmission metric 16,17,20,21 .…”

Section: Introductionmentioning

confidence: 99%

Changing Dynamics of HIV Transmission in Côte d'Ivoire: Modeling Who Acquired and Transmitted Infections and Estimating the Impact of Past HIV Interventions (1976–2015)

Maheu‐Giroux

Vesga

Diabaté

et al. 2017

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Introduction Understanding the impact of past interventions and how it affected transmission dynamics is key to guiding prevention efforts. We estimated the population-level impact of condom, antiretroviral therapy (ART), and prevention of mother-to-child transmission activities on HIV transmission and the contribution of key risk factors on HIV acquisition and transmission. Methods An age stratified dynamical model of sexual and vertical HIV transmission among the general population, female sex workers (FSW), and men who have sex with men (MSM) was calibrated to detailed prevalence and intervention data. We estimated the fraction of HIV infections averted by the interventions, and the fraction of incident infections acquired and transmitted by different populations over successive 10-year periods (1976-2015). Results Overall, condom use averted 61% (95% Credible Intervals: 56-66%) of all adult infections during 1987-2015 mainly due to increases by FSW (46% of infections averted). In comparison, ART prevented 15% (10-19%) of adult infections during 2010-2015. As a result, FSW initially (1976-1985) contributed 95% (91-97%) of all new infections, declining to 19% (11-27%) during 2005-2015. Older men and clients mixing with non-FSW are currently the highest contributor to transmission. MSM contributed ≤4% of transmission throughout. Young women (15-24 years; excluding FSW) did not transmit more infection than they acquired. Conclusion Early increases in condom use, mainly by FSW, have substantially reduced HIV transmission. Clients of FSW and older men have become the main source of transmission whereas young women remain at increased risk. Strengthening prevention and scaling-up of ART, particularly to FSW and CFSW, is important.

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“…Malaria can be characterized by acquired immunity or, like HIV, a long asymptomatic and infectious period, particularly in the case of Plasmodium vivax [20]. In HIV, these circumstances have led to distributions of reported cases that often do not reflect the relative contribution of different subpopulations to transmission or the current epidemiological situation [21]. …”

Section: Introductionmentioning

confidence: 99%

Surveillance and response for high-risk populations: what can malaria elimination programmes learn from the experience of HIV?

Jacobson

Cueto

Smith

et al. 2017

Malar J

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To eliminate malaria, malaria programmes need to develop new strategies for surveillance and response appropriate for the changing epidemiology that accompanies transmission decline, in which transmission is increasingly driven by population subgroups whose behaviours place them at increased exposure. Conventional tools of malaria surveillance and response are likely not sufficient in many elimination settings for accessing high-risk population subgroups, such as mobile and migrant populations (MMPs), given their greater likelihood of asymptomatic infections, illegal risk behaviours, limited access to public health facilities, and high mobility including extended periods travelling away from home. More adaptive, targeted strategies are needed to monitor transmission and intervention coverage effectively in these groups. Much can be learned from HIV programmes’ experience with “second generation surveillance”, including how to rapidly adapt surveillance and response strategies to changing transmission patterns, biological and behavioural surveys that utilize targeted sampling methods for specific behavioural subgroups, and methods for population size estimation. This paper reviews the strategies employed effectively for HIV programmes and offers considerations and recommendations for adapting them to the malaria elimination context.

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Distinguishing sources of HIV transmission from the distribution of newly acquired HIV infections: why is it important for HIV prevention planning?

Cited by 31 publications

References 21 publications

Positive Impact of Increases in Condom Use among Female Sex Workers and Clients in a Medium HIV Prevalence Epidemic: Modelling Results from Project SIDA1/2/3 in Cotonou, Benin

Positive Impact of Increases in Condom Use among Female Sex Workers and Clients in a Medium HIV Prevalence Epidemic: Modelling Results from Project SIDA1/2/3 in Cotonou, Benin

Changing Dynamics of HIV Transmission in Côte d'Ivoire: Modeling Who Acquired and Transmitted Infections and Estimating the Impact of Past HIV Interventions (1976–2015)

Surveillance and response for high-risk populations: what can malaria elimination programmes learn from the experience of HIV?

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