Aditya Khanna1, Steven M Goodreau2, Dan Wohlfeiler3, Eric Daar4, Susan Little5, Pamina M Gorbach6. 1. Department of Medicine, University of Chicago, Chicago, IL. Electronic address: akhanna@medicine.bsd.uchicago.edu. 2. Department of Anthropology, University of Washington, Seattle, WA. 3. Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, CA. 4. David Geffen School of Medicine, University of California, Los Angeles, CA. 5. Department of Medicine, University of California, San Diego, CA. 6. Fielding School of Public Health, David Geffen School of Medicine, University of California, Los Angeles, CA.
Abstract
PURPOSE: In this article, we examine the effectiveness of a variety of HIV diagnosis interventions in recently HIV-diagnosed men who have sex with men (MSM). These interventions use the preventive potential of postdiagnosis behavior change (PDBC), as measured by the reduction in the number of new infections. Empirical evidence for PDBC was presented in the behavioral substudy of the Southern California Acute Infection and Early Disease Research Program. In previous modeling work, we demonstrated the existing preventive effects of PDBC. However, a large proportion of new infections among MSM are either undiagnosed or diagnosed late, and the preventive potential of PDBC is not fully utilized. METHODS: We derive empirical, stochastic, network-based models to examine the effectiveness of several diagnosis interventions that account for PDBC among MSM over a 10-year period. These interventions involve tests with shorter detection windows, more frequent testing, and individualized testing regimens. RESULTS: We find that individualized testing interventions (i.e., testing individuals every three partners or 3 months, whichever is first, or every six partners or 6 months, whichever is first) result in significantly fewer new HIV infections than the generalized interventions we consider. CONCLUSIONS: This work highlights the potential of individualized interventions for new public health policies in HIV prevention.
PURPOSE: In this article, we examine the effectiveness of a variety of HIV diagnosis interventions in recently HIV-diagnosed men who have sex with men (MSM). These interventions use the preventive potential of postdiagnosis behavior change (PDBC), as measured by the reduction in the number of new infections. Empirical evidence for PDBC was presented in the behavioral substudy of the Southern California Acute Infection and Early Disease Research Program. In previous modeling work, we demonstrated the existing preventive effects of PDBC. However, a large proportion of new infections among MSM are either undiagnosed or diagnosed late, and the preventive potential of PDBC is not fully utilized. METHODS: We derive empirical, stochastic, network-based models to examine the effectiveness of several diagnosis interventions that account for PDBC among MSM over a 10-year period. These interventions involve tests with shorter detection windows, more frequent testing, and individualized testing regimens. RESULTS: We find that individualized testing interventions (i.e., testing individuals every three partners or 3 months, whichever is first, or every six partners or 6 months, whichever is first) result in significantly fewer new HIV infections than the generalized interventions we consider. CONCLUSIONS: This work highlights the potential of individualized interventions for new public health policies in HIV prevention.
Authors: Susan H Eshleman; Leila Khaki; Oliver Laeyendecker; Estelle Piwowar-Manning; LeTanya Johnson-Lewis; Marla Husnik; Beryl Koblin; Thomas Coates; Margaret Chesney; Ana Vallari; Sushil G Devare; John Hackett Journal: J Acquir Immune Defic Syndr Date: 2009-09-01 Impact factor: 3.731
Authors: Jeffrey A Kelly; Stephen F Morin; Robert H Remien; Wayne T Steward; Jenny A Higgins; David W Seal; Robert Dubrow; J H Atkinson; Peter R Kerndt; Steven D Pinkerton; Kenneth Mayer; Kathleen J Sikkema Journal: AIDS Behav Date: 2009-06-06
Authors: Donna J Helms; Hillard S Weinstock; Kristen C Mahle; Kyle T Bernstein; Bruce W Furness; Charlotte K Kent; Cornelis A Rietmeijer; Akbar M Shahkolahi; James P Hughes; Matthew R Golden Journal: J Acquir Immune Defic Syndr Date: 2009-03-01 Impact factor: 3.731
Authors: Patrick S Sullivan; Michael S Lyons; Maggie Czarnogorski; Bernard M Branson Journal: Public Health Rep Date: 2016 Jan-Feb Impact factor: 2.792
Authors: Elizabeth A DiNenno; Joseph Prejean; Kevin P Delaney; Kristina Bowles; Tricia Martin; Amrita Tailor; Gema Dumitru; Mary M Mullins; Angela Hutchinson; Amy Lansky Journal: Public Health Rep Date: 2017-11-28 Impact factor: 2.792
Authors: Aditya S Khanna; John A Schneider; Nicholson Collier; Jonathan Ozik; Rodal Issema; Angela di Paola; Abigail Skwara; Arthi Ramachandran; Jeannette Webb; Russell Brewer; William Cunningham; Charles Hilliard; Santhoshini Ramani; Kayo Fujimoto; Nina Harawa Journal: AIDS Date: 2019-10-01 Impact factor: 4.177
Authors: Kevin P Delaney; Eli S Rosenberg; Michael R Kramer; Lance A Waller; Patrick S Sullivan Journal: Open Forum Infect Dis Date: 2015-10-20 Impact factor: 3.835