Improvements in the HIV care continuum needed to meaningfully reduce HIV incidence among men who have sex with men in Baltimore, US: a modelling study for HPTN 078.
HIV infections
United States
forecasting
homosexuality, male
incidence
models, theoretical
Journal
Journal of the International AIDS Society
ISSN: 1758-2652
Titre abrégé: J Int AIDS Soc
Pays: Switzerland
ID NLM: 101478566
Informations de publication
Date de publication:
03 2019
03 2019
Historique:
received:
28
09
2018
accepted:
18
01
2019
entrez:
15
3
2019
pubmed:
15
3
2019
medline:
29
1
2020
Statut:
ppublish
Résumé
HIV prevalence is high among men who have sex with men (MSM) in Baltimore, Maryland, United States, and the levels of viral suppression among HIV-positive MSM are relatively low. The HIV Prevention Trials Network 078 trial seeks to increase the levels of viral suppression among US MSM by increasing the rates of diagnosis and linkage to care and treatment. We estimated the increases in viral suppression needed to reach different HIV incidence reduction targets, and the impact of meeting diagnosis and treatment targets. We used a mathematical model of HIV transmission among MSM from Baltimore, US, parameterised with behavioural data and fitted to HIV prevalence and care continuum data for Baltimore wherever possible, to project increases in viral suppression needed to reduce the HIV incidence rate among Baltimore MSM by 10, 20, 30 or 50% after 2, 5 and 10 years. We also projected HIV incidence reductions achieved if US national targets - 90% of people living with HIV (PLHIV) know their HIV serostatus, 90% of those diagnosed are retained in HIV medical care and 80% of those diagnosed are virally suppressed - or UNAIDS 90-90-90 targets (90% of PLHIV know their status, 90% of those diagnosed receive antiretroviral therapy (ART), 90% of those receiving ART are virally suppressed) are each met by 2020. To reduce the HIV incidence rate by 20% and 50% after five years (compared with the base-case at the same time point), the proportion of all HIV-positive MSM who are virally suppressed must increase above 2015 levels by a median 13 percentage points (95% uncertainty interval 9 to 16 percentage points) from median 49% to 60%, and 27 percentage points (22 to 35) from 49% to 75% respectively. Meeting all three US or 90-90-90 UNAIDS targets results in a 48% (31% to 63%) and 51% (38% to 65%) HIV incidence rate reduction in 2020 respectively. Substantial improvements in levels of viral suppression will be needed to achieve significant incidence reductions among MSM in Baltimore, and to meet 2020 US and UNAIDS targets. Future modelling studies should additionally consider the impact of pre-exposure prophylaxis for MSM.
Identifiants
pubmed: 30868739
doi: 10.1002/jia2.25246
pmc: PMC6416473
doi:
Substances chimiques
Anti-HIV Agents
0
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
e25246Subventions
Organisme : NIAID NIH HHS
ID : P30 AI094189
Pays : United States
Organisme : Medical Research Council
ID : MR/R015600/1
Pays : United Kingdom
Organisme : NIAID NIH HHS
ID : UM1 AI068619
Pays : United States
Organisme : NIDA NIH HHS
ID : K01 DA041259
Pays : United States
Organisme : NIAID NIH HHS
ID : UM1 AI068617
Pays : United States
Informations de copyright
© 2019 The Authors. Journal of the International AIDS Society published by John Wiley & Sons Ltd on behalf of the International AIDS Society.
Références
N Engl J Med. 2012 Aug 2;367(5):411-22
pubmed: 22784040
Ann Epidemiol. 2015 Jun;25(6):445-54
pubmed: 25911980
HIV Clin Trials. 2011 Jul-Aug;12(4):190-200
pubmed: 22044855
Lancet HIV. 2016 Mar;3(3):e140-6
pubmed: 26939737
Lancet. 2009 Jan 3;373(9657):48-57
pubmed: 19038438
J Int Assoc Provid AIDS Care. 2014 May-Jun;13(3):232-41
pubmed: 24493009
J Acquir Immune Defic Syndr. 2015 Sep 1;70(1):23-32
pubmed: 25886926
AIDS. 2015 Nov 28;29(18):2435-46
pubmed: 26558543
J Acquir Immune Defic Syndr. 2007 Dec 15;46(5):607-15
pubmed: 18043315
J Acquir Immune Defic Syndr Hum Retrovirol. 1998;17 Suppl 1:S38-41
pubmed: 9586651
AIDS Res Hum Retroviruses. 2010 Aug;26(8):875-81
pubmed: 20672995
J Acquir Immune Defic Syndr. 2005 Mar 1;38(3):320-8
pubmed: 15735452
N Engl J Med. 2016 Sep 1;375(9):830-9
pubmed: 27424812
J Acquir Immune Defic Syndr. 2017 Jul 1;75 Suppl 3:S296-S308
pubmed: 28604431
J Acquir Immune Defic Syndr. 2015 Mar 1;68(3):337-44
pubmed: 25469526
PLoS One. 2015 Jul 15;10(7):e0132962
pubmed: 26176856
J Int AIDS Soc. 2019 Mar;22(3):e25246
pubmed: 30868739
Public Health Rep. 2007;122 Suppl 1:39-47
pubmed: 17354526
Am J Prev Med. 2017 Sep;53(3):275-281
pubmed: 28522237
PLoS One. 2011;6(8):e17502
pubmed: 21826193
JAMA Intern Med. 2013 Jul 22;173(14):1337-44
pubmed: 23780395
Lancet. 2016 Jan 2;387(10013):53-60
pubmed: 26364263
MMWR Morb Mortal Wkly Rep. 2016 Feb 05;65(4):77-82
pubmed: 26844978
N Engl J Med. 2011 Aug 11;365(6):493-505
pubmed: 21767103
Clin Infect Dis. 2014 Apr;58(8):1185-9
pubmed: 24463281
J Acquir Immune Defic Syndr. 2009 Dec;52(5):574-80
pubmed: 19755913
Science. 2013 Feb 22;339(6122):966-71
pubmed: 23430656
PLoS One. 2013 Oct 23;8(10):e76878
pubmed: 24194848
J Acquir Immune Defic Syndr. 2015 Jul 1;69(3):257-63
pubmed: 25886932
PLoS One. 2012;7(4):e34972
pubmed: 22529964
Clin Infect Dis. 2012 Nov;55(9):1242-51
pubmed: 23019271
Lancet. 2013 Jun 15;381(9883):2083-90
pubmed: 23769234
Proc Natl Acad Sci U S A. 2017 Apr 11;114(15):4017-4022
pubmed: 28320938
JAMA. 2016 Jul 12;316(2):171-81
pubmed: 27404185
MMWR Morb Mortal Wkly Rep. 2015 Jun 26;64(24):657-62
pubmed: 26110835
J Acquir Immune Defic Syndr. 2013 Mar 1;62(3):356-62
pubmed: 23242158
AIDS Behav. 2012 Apr;16(3):543-53
pubmed: 21964976
MMWR Morb Mortal Wkly Rep. 2014 Sep 26;63(38):829-33
pubmed: 25254559