Estimating the contribution of key populations towards HIV transmission in South Africa
| Autor: | Mfezi Mcingana, Sharmistha Mishra, Sheree Schwartz, Christinah Mukandavire, Nancy Phaswana-Mafuya, Tim Lane, Stefan Baral, Adrian Puren, Alexander Marr, Marie-Claude Boily, Minja Milovanovic, Fern Terris-Prestholt, Peter Vickerman, Kennedy Otwombe, Hannah Fraser, Glenda Gray, Amrita Rao, Zamakayise Kose, Jack Stone, Katharine J. Looker, Harry Hausler, Jenny Coetzee, Manezi Ncedani, Matthew Quaife, Gillian Hunt, Katherine Young |
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| Přispěvatelé: | United States Agency for International Development (USAID) |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty clients Population Human immunodeficiency virus (HIV) men who have sex with men HIV Infections medicine.disease_cause Models Biological 1117 Public Health and Health Services Men who have sex with men Sexual and Gender Minorities South Africa Young Adult 03 medical and health sciences 0302 clinical medicine Epidemiology medicine Humans key populations mathematical modelling 030212 general & internal medicine Homosexuality Male education Hiv transmission female sex workers Research Articles education.field_of_study Sex Workers 030505 public health Mathematical modelling Transmission (medicine) business.industry Public Health Environmental and Occupational Health Female sex virus diseases 1103 Clinical Sciences Middle Aged Sex Work Infectious Diseases Female population attributable fraction 0305 other medical science business 1199 Other Medical and Health Sciences Research Article Demography |
| Zdroj: | Stone, J, Mukandavire, C, Boily, M-C, Fraser, H, Mishra, S, Schwartz, S, Rao, A, Looker, K J, Quaife, M, Terris-Prestholt, F, Marr, A, Lane, T, Coetzee, J, Hausler, H, Young, K, Mcingana, M, Ncedani, M, Puren, A, Hunt, G, Kose, Z, Phaswana-Mafuya, N, Baral, S D & Vickerman, P T 2021, ' Estimating the contribution of key populations towards HIV transmission in South Africa ', Journal of the International AIDS Society, vol. 24, no. 1, e25650 . https://doi.org/10.1002/jia2.25650 Journal of the International AIDS Society |
| ISSN: | 1758-2652 |
| Popis: | Introduction In generalized epidemic settings, there is insufficient understanding of how the unmet HIV prevention and treatment needs of key populations (KPs), such as female sex workers (FSWs) and men who have sex with men (MSM), contribute to HIV transmission. In such settings, it is typically assumed that HIV transmission is driven by the general population. We estimated the contribution of commercial sex, sex between men, and other heterosexual partnerships to HIV transmission in South Africa (SA). Methods We developed the “Key‐Pop Model”; a dynamic transmission model of HIV among FSWs, their clients, MSM, and the broader population in SA. The model was parameterized and calibrated using demographic, behavioural and epidemiological data from national household surveys and KP surveys. We estimated the contribution of commercial sex, sex between men and sex among heterosexual partnerships of different sub‐groups to HIV transmission over 2010 to 2019. We also estimated the efficiency (HIV infections averted per person‐year of intervention) and prevented fraction (% IA) over 10‐years from scaling‐up ART (to 81% coverage) in different sub‐populations from 2020. Results Sex between FSWs and their paying clients, and between clients with their non‐paying partners contributed 6.9% (95% credibility interval 4.5% to 9.3%) and 41.9% (35.1% to 53.2%) of new HIV infections in SA over 2010 to 2019 respectively. Sex between low‐risk groups contributed 59.7% (47.6% to 68.5%), sex between men contributed 5.3% (2.3% to 14.1%) and sex between MSM and their female partners contributed 3.7% (1.6% to 9.8%). Going forward, the largest population‐level impact on HIV transmission can be achieved from scaling up ART to clients of FSWs (% IA = 18.2% (14.0% to 24.4%) or low‐risk individuals (% IA = 20.6% (14.7 to 27.5) over 2020 to 2030), with ART scale‐up among KPs being most efficient. Conclusions Clients of FSWs play a fundamental role in HIV transmission in SA. Addressing the HIV prevention and treatment needs of KPs in generalized HIV epidemics is central to a comprehensive HIV response. |
| Databáze: | OpenAIRE |
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