Population-level impact of an accelerated HIV response plan to reach the UNAIDS 90-90-90 target in Côte d’Ivoire: Insights from mathematical modeling
Publication Date
June 15, 2017
Journal
PLOS Medicine
Authors
Mathieu Maheu-Giroux, Juan F. Vesga, Souleymane Diabaté, Michel Alary, et al
Volume
14
Issue
6
Pages
e1002321
DOI
https://dx.plos.org/10.1371/journal.pmed.1002321
Publisher URL
http://journals.plos.org/plosmedicine/article?id=10.1371%2Fjournal.pmed.1002321
Scopus
85019948845
Mendeley
http://www.mendeley.com/research/populationlevel-impact-accelerated-hiv-response-plan-reach-unaids-909090-target-c%C3%B4te-divoire-insight
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Mendeley | Further Information

{"title"=>"Population-level impact of an accelerated HIV response plan to reach the UNAIDS 90-90-90 target in Côte d’Ivoire: Insights from mathematical modeling", "type"=>"journal", "authors"=>[{"first_name"=>"Mathieu", "last_name"=>"Maheu-Giroux", "scopus_author_id"=>"15035841700"}, {"first_name"=>"Juan F.", "last_name"=>"Vesga", "scopus_author_id"=>"23987062100"}, {"first_name"=>"Souleymane", "last_name"=>"Diabaté", "scopus_author_id"=>"18436626100"}, {"first_name"=>"Michel", "last_name"=>"Alary", "scopus_author_id"=>"7006788290"}, {"first_name"=>"Stefan", "last_name"=>"Baral", "scopus_author_id"=>"21833280200"}, {"first_name"=>"Daouda", "last_name"=>"Diouf", "scopus_author_id"=>"54681821800"}, {"first_name"=>"Kouamé", "last_name"=>"Abo", "scopus_author_id"=>"56544307500"}, {"first_name"=>"Marie Claude", "last_name"=>"Boily", "scopus_author_id"=>"7003395873"}], "year"=>2017, "source"=>"PLoS Medicine", "identifiers"=>{"scopus"=>"2-s2.0-85019948845", "sgr"=>"85019948845", "doi"=>"10.1371/journal.pmed.1002321", "pui"=>"617179183", "pmid"=>"28617810", "isbn"=>"1111111111", "issn"=>"15491676"}, "id"=>"eda473c4-a3a5-3bf3-aa5f-7496b6d52fd1", "abstract"=>"BACKGROUND National responses will need to be markedly accelerated to achieve the ambitious target of the Joint United Nations Programme on HIV/AIDS (UNAIDS). This target aims for 90% of HIV-positive individuals to be aware of their status, for 90% of those aware to receive antiretroviral therapy (ART), and for 90% of those on treatment to have a suppressed viral load by 2020, with each individual target reaching 95% by 2030. We aimed to estimate the impact of various treatment-as-prevention scenarios in Côte d'Ivoire, one of the countries with the highest HIV incidence in West Africa, with unmet HIV prevention and treatment needs, and where key populations are important to the broader HIV epidemic. METHODS AND FINDINGS An age-stratified dynamic model was developed and calibrated to epidemiological and programmatic data using a Bayesian framework. The model represents sexual and vertical HIV transmission in the general population, female sex workers (FSW), and men who have sex with men (MSM). We estimated the impact of scaling up interventions to reach the UNAIDS targets, as well as the impact of 8 other scenarios, on HIV transmission in adults and children, compared to our baseline scenario that maintains 2015 rates of testing, ART initiation, ART discontinuation, treatment failure, and levels of condom use. In 2015, we estimated that 52% (95% credible intervals: 46%-58%) of HIV-positive individuals were aware of their status, 72% (57%-82%) of those aware were on ART, and 77% (74%-79%) of those on ART were virologically suppressed. Reaching the UNAIDS targets on time would avert 50% (42%-60%) of new HIV infections over 2015-2030 compared to 30% (25%-36%) if the 90-90-90 target is reached in 2025. Attaining the UNAIDS targets in FSW, their clients, and MSM (but not in the rest of the population) would avert a similar fraction of new infections (30%; 21%-39%). A 25-percentage-point drop in condom use from the 2015 levels among FSW and MSM would reduce the impact of reaching the UNAIDS targets, with 38% (26%-51%) of infections averted. The study's main limitation is that homogenous spatial coverage of interventions was assumed, and future lines of inquiry should examine how geographical prioritization could affect HIV transmission. CONCLUSIONS Maximizing the impact of the UNAIDS targets will require rapid scale-up of interventions, particularly testing, ART initiation, and limiting ART discontinuation. Reaching clients of FSW, as well as key populations, can efficiently reduce transmission. Sustaining the high condom-use levels among key populations should remain an important prevention pillar.", "link"=>"http://www.mendeley.com/research/populationlevel-impact-accelerated-hiv-response-plan-reach-unaids-909090-target-c%C3%B4te-divoire-insight", "reader_count"=>28, "reader_count_by_academic_status"=>{"Unspecified"=>3, "Researcher"=>5, "Student > Doctoral Student"=>3, "Student > Ph. D. Student"=>4, "Student > Postgraduate"=>1, "Student > Master"=>7, "Other"=>2, "Student > Bachelor"=>1, "Lecturer"=>2}, "reader_count_by_user_role"=>{"Unspecified"=>3, "Researcher"=>5, "Student > Doctoral Student"=>3, "Student > Ph. D. Student"=>4, "Student > Postgraduate"=>1, "Student > Master"=>7, "Other"=>2, "Student > Bachelor"=>1, "Lecturer"=>2}, "reader_count_by_subject_area"=>{"Unspecified"=>5, "Nursing and Health Professions"=>4, "Mathematics"=>2, "Medicine and Dentistry"=>10, "Agricultural and Biological Sciences"=>2, "Social Sciences"=>3, "Earth and Planetary Sciences"=>1, "Pharmacology, Toxicology and Pharmaceutical Science"=>1}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>10}, "Social Sciences"=>{"Social Sciences"=>3}, "Earth and Planetary Sciences"=>{"Earth and Planetary Sciences"=>1}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>2}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>4}, "Mathematics"=>{"Mathematics"=>2}, "Unspecified"=>{"Unspecified"=>5}, "Pharmacology, Toxicology and Pharmaceutical Science"=>{"Pharmacology, Toxicology and Pharmaceutical Science"=>1}}, "group_count"=>1}

Scopus | Further Information

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