Romain Silhol1,2, Marie-Claude Boily1,2, Dobromir Dimitrov3, Danielle German4, Colin Flynn5, Jason E Farley6,7, Marcy Gelman8, James P Hughes3,9, Deborah Donnell3, Adeola Adeyeye10, Robert H Remien11, Chris Beyrer4, Gabriela Paz-Bailey12, Cyprian Wejnert12, Kate M Mitchell1,2. 1. Department of Infectious Disease Epidemiology, Medical Research Council Centre for Global Infectious Disease Analysis, Imperial College London, London, United Kingdom. 2. Department of Infectious Disease Epidemiology, HIV Prevention Trials Network Modelling Centre, Imperial College London, London, United Kingdom. 3. Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA. 4. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. 5. Maryland Department of Health, Baltimore, MD. 6. The REACH Initiative, Johns Hopkins University School of Nursing, Baltimore, MD. 7. HPTN, The Johns Hopkins University School of Medicine, Baltimore, MD. 8. Fenway Institute, Boston, MA. 9. Department of Biostatistics, University of Washington, Seattle, WA. 10. Division of AIDS, National Institutes of Health, Washington, DC. 11. HIV Center for Clinical and Behavioral Studies, NY State Psychiatric Institute and Columbia University, New York, NY. 12. Centers for Disease Control and Prevention, Atlanta, GA.
Abstract
INTRODUCTION: Men who have sex with men (MSM) in the United States are disproportionately affected by HIV. We estimated the impact of past interventions and contribution of different population groups to incident MSM HIV infections. SETTING: Baltimore, US. METHODS: We used a deterministic model, parameterized and calibrated to demographic and epidemic Baltimore MSM data, to estimate the fraction of HIV infections among MSM averted by condoms and antiretroviral therapy (ART) over 1984-2017 and the fraction of infections acquired and transmission contributed by MSM from different demographic groups and disease and care continuum stages over 10-year periods from 1988 to 2017, using population attributable fractions. RESULTS: Condom use and ART averted 19% (95% uncertainty interval: 14%-25%) and 23% (15%-31%) of HIV infections that would have occurred since 1984 and 1996, respectively. Over 2008-2017, 46% (41%-52%) of incident infections were acquired by and 35% (27%-49%) of transmissions contributed by MSM aged 18-24 years (who constitute 27% of all MSM, 19% of HIV+ MSM). MSM with undiagnosed HIV infection, those with diagnosed infection but not in care, and those on ART contributed to 41% (31%-54%), 46% (25%-56%), and 14% (7%-28%) of transmissions, respectively. CONCLUSION: Condoms and ART have modestly impacted the HIV epidemic among Baltimore MSM to date. Interventions reaching MSM with diagnosed infection who are not in care should be implemented because the largest percentage of HIV transmissions among Baltimore MSM is attributed to this group.
INTRODUCTION:Men who have sex with men (MSM) in the United States are disproportionately affected by HIV. We estimated the impact of past interventions and contribution of different population groups to incident MSM HIV infections. SETTING: Baltimore, US. METHODS: We used a deterministic model, parameterized and calibrated to demographic and epidemic Baltimore MSM data, to estimate the fraction of HIV infections among MSM averted by condoms and antiretroviral therapy (ART) over 1984-2017 and the fraction of infections acquired and transmission contributed by MSM from different demographic groups and disease and care continuum stages over 10-year periods from 1988 to 2017, using population attributable fractions. RESULTS: Condom use and ART averted 19% (95% uncertainty interval: 14%-25%) and 23% (15%-31%) of HIV infections that would have occurred since 1984 and 1996, respectively. Over 2008-2017, 46% (41%-52%) of incident infections were acquired by and 35% (27%-49%) of transmissions contributed by MSM aged 18-24 years (who constitute 27% of all MSM, 19% of HIV+ MSM). MSM with undiagnosed HIV infection, those with diagnosed infection but not in care, and those on ART contributed to 41% (31%-54%), 46% (25%-56%), and 14% (7%-28%) of transmissions, respectively. CONCLUSION: Condoms and ART have modestly impacted the HIV epidemic among Baltimore MSM to date. Interventions reaching MSM with diagnosed infection who are not in care should be implemented because the largest percentage of HIV transmissions among Baltimore MSM is attributed to this group.
Authors: Andrea L Wirtz; Paul A Burns; Tonia Poteat; Mannat Malik; Jordan J White; Durryle Brooks; Parastu Kasaie; Chris Beyrer Journal: AIDS Behav Date: 2022-06-04
Authors: Jason E Farley; Derek T Dangerfield; Jessica LaRicci; Paul Sacamano; Omeid Heidari; Kelly Lowensen; Jacky M Jennings; Karin E Tobin Journal: Public Health Nurs Date: 2021-03-22 Impact factor: 1.462