Dynamic Sex Roles Among Men Who Have Sex With Men and Transmissions From Primary HIV Infection

Alam, Shah Jamal; Romero-Severson, Ethan; Kim, Jong-Hoon; Émond, Gilbert; Koopman, James S.

doi:10.1097/ede.0b013e3181e9e901

Cited by 20 publications

(19 citation statements)

References 16 publications

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“…80 Interventions that rely on identifying and treating HIV-infected persons will have little to no effect on transmission, particularly among MSM with multiple partnerships of various durations and sexual behaviours during early infection. 81,82 Cohen et al argue that 38% of incident HIV infections arise from contact with early HIV infection index cases during the first 4.8 months. Others argue that this is too high, proposing instead that only 2-4% of incident infections occur during acute HIV infection, and that annual testing and immediate treatment would still be sufficient to eliminate transmission.…”

Section: Treatment Of Acute and Early Hiv Infectionmentioning

confidence: 99%

“…Others argue that this is too high, proposing instead that only 2-4% of incident infections occur during acute HIV infection, and that annual testing and immediate treatment would still be sufficient to eliminate transmission. 82 However, little is known about acute and early HIV infection in Asia, with the exception of China and Thailand. Adding strategies for earlier detection of HIV-1 infection using pooled HIV nucleic acid amplification testing in antibody-negative blood samples from high-incidence populations of MSM was considered effective for intervening early with behavioural interventions and earlier treatment during a period with such a high transmission risk in Bangkok, Thailand, 83,84 and Lianing province, China.…”

Section: Treatment Of Acute and Early Hiv Infectionmentioning

confidence: 99%

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Challenges and potential barriers to the uptake of antiretroviral-based prevention in Asia and the Pacific region

Kato²,

Phanuphak

et al. 2014

Sex. Health

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Abstract. Evidence has emerged over the past few years on the effectiveness of antiretroviral-based prevention technologies to prevent (i) HIV transmission while decreasing morbidity and mortality in HIV-infected persons, and (ii) HIV acquisition in HIV-uninfected individuals through pre-exposure prophylaxis (PrEP). Only few of the planned studies on treatment as prevention (TasP) are conducted in Asia. TasP might be more feasible and effective in concentrated rather than in generalised epidemics, as resources for HIV testing and antiretroviral treatment could focus on confined and much smaller populations than in the generalised epidemics observed in sub-Saharan Africa. Several countries such as Cambodia, China, Thailand and Vietnam, are now paving the way to success. Similar challenges arise for both TasP and PrEP. However, the operational issues for PrEP are amplified by the need for frequent retesting and ensuring adherence. This paper describes challenges for the implementation of antiretroviral-based prevention and makes the case that TasP and PrEP implementation research in Asia is much needed to provide insights into the feasibility of these interventions in populations where firm evidence of 'real world' effectiveness is still lacking.

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Section: Treatment Of Acute and Early Hiv Infectionmentioning

confidence: 99%

Section: Treatment Of Acute and Early Hiv Infectionmentioning

confidence: 99%

Challenges and potential barriers to the uptake of antiretroviral-based prevention in Asia and the Pacific region

Kato²,

Phanuphak

et al. 2014

Sex. Health

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“…Such investigation may result in some crucial parameter estimates such as fluctuating infectivity over various disease stages [29,50]. The influences of differing key behavioural parameters such as sexual contact patterns between sexual activity groups [39,49,[51][52][53][54][55][56][57], age [34,58,59], and MSM sexual role separation [60][61][62], have been widely studied. Anal sex was the main and often the only route of HIV transmission in the models.…”

Section: Investigation Into Effects Of Hiv-transmission-related Charamentioning

confidence: 99%

“…Faster spread [54] Higher partnership concurrency Faster initial spread followed by a slower phase [125] Higher number of dual-role MSM Higher HIV incidence [8,60,61] Higher proportion of new infections from primary HIV infections stage [62] Higher number of partners of dual-role MSM Higher HIV prevalence [43] Mixing pattern…”

Section: Effects Of Parameter Uncertainty On Hiv Epidemic Forecastsmentioning

confidence: 99%

Mathematical models for the study of HIV spread and control amongst men who have sex with men

et al. 2011

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For a quarter of century, mathematical models have been used to study the spread and control of HIV amongst men who have sex with men (MSM). We searched MEDLINE and EMBASE databases up to the end of 2010 and reviewed this literature to summarise the methodologies used, key model developments, and the recommended strategies for HIV control amongst MSM. Of 742 studies identified, 127 studies met the inclusion criteria. Most studies employed deterministic modelling methods (80%). Over time we saw an increase in model complexity regarding antiretroviral therapy (ART), and a corresponding decrease in complexity regarding sexual behaviours. Formal estimation of model parameters was carried out in only a small proportion of the studies (22%) while model validation was considered by an even smaller proportion (17%), somewhat reducing confidence in the findings from the studies. Nonetheless, a number of common conclusions emerged, including (1) identification of the importance of assumptions regarding changes in infectivity and sexual contact rates on the impact of ART on HIV incidence, that subsequently led to empirical studies to gather these data, and (2) recommendation that multiple strategies would be required for effective HIV control amongst MSM. The role of mathematical models in studying epidemics is clear, and the lack of formal inference and validation highlights the need for further developments in this area. Improved methodologies for parameter estimation and systematic sensitivity analysis will help generate predictions that more fully express uncertainty, allowing better informed decision making in public health.

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“…4,5 Previous theoretical work has identified several key factors such as general contact structure, heterogeneity in contact rates between individuals, partnership behavior, and sexual-role dynamics, among others as factors that can promote or suppress population-level acute-stage HIV transmission. [6][7][8][9][10] Some of these effects can be quite strong, increasing acute-state incidence by over 40-fold, compared with a model without the given effect. 11 We argue that, in addition to other known factors, individual-level changes in sexual contact rates over time must be considered in any full assessment of the role and the rate of acute-stage HIV transmission.…”

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confidence: 99%

Acute-Stage Transmission of HIV

et al. 2013

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The extent of changes in individual-level contact rates in the real world is unknown. Aggregate or strictly cross-sectional data do not reveal individual-level changes in partnership dynamics and sexual behavior. The strong effects presented in this article motivate both continued theoretical exploration of volatility in sexual behavior and collection of longitudinal individual-level data to inform more realistic models.

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Dynamic Sex Roles Among Men Who Have Sex With Men and Transmissions From Primary HIV Infection

Abstract: Background-Previous studies estimating the fraction of transmissions from persons with primary HIV have not focused on the effects of switching sex role in male homosexual populations. Such behavioral fluctuations can increase the contribution of primary HIV in the overall population.

Cited by 20 publications

References 16 publications

Challenges and potential barriers to the uptake of antiretroviral-based prevention in Asia and the Pacific region

Challenges and potential barriers to the uptake of antiretroviral-based prevention in Asia and the Pacific region

Mathematical models for the study of HIV spread and control amongst men who have sex with men

Acute-Stage Transmission of HIV

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