Combination HIV prevention among MSM in South Africa: results from agent-based modeling

Show simple item record 2014-11-19 en 2022-08-17T16:48:25Z 2022-08-17T16:48:25Z 2015-08-25 en
dc.description.abstract HIV prevention trials have demonstrated the effectiveness of a number of behavioral and biomedical interventions. HIV prevention packages are combinations of interventions and offer potential to significantly increase the effectiveness of any single intervention. Estimates of the effectiveness of prevention packages are important for guiding the development of prevention strategies and for characterizing effect sizes before embarking on large scale trials. Unfortunately, most research to date has focused on testing single interventions rather than HIV prevention packages. Here we report the results from agent-based modeling of the effectiveness of HIV prevention packages for men who have sex with men (MSM) in South Africa. We consider packages consisting of four components: antiretroviral therapy for HIV infected persons with CD4 count <350; PrEP for high risk uninfected persons; behavioral interventions to reduce rates of unprotected anal intercourse (UAI); and campaigns to increase HIV testing. We considered 163 HIV prevention packages corresponding to different intensity levels of the four components. We performed 2252 simulation runs of our agent-based model to evaluate those packages. We found that a four component package consisting of a 15% reduction in the rate of UAI, 50% PrEP coverage of high risk uninfected persons, 50% reduction in persons who never test for HIV, and 50% ART coverage over and above persons already receiving ART at baseline, could prevent 33.9% of infections over 5 years (95% confidence interval, 31.5, 36.3). The package components with the largest incremental prevention effects were UAI reduction and PrEP coverage. The impact of increased HIV testing was magnified in the presence of PrEP. We find that HIV prevention packages that include both behavioral and biomedical components can in combination prevent significant numbers of infections with levels of coverage, acceptance and adherence that are potentially achievable among MSM in South Africa. en
dc.format.medium Print en
dc.publisher Public Library Science en
dc.subject RISK BEHAVIOUR en
dc.subject MEN en
dc.subject HOMOSEXUALITY en
dc.subject SEXUAL BEHAVIOUR en
dc.subject HIV/AIDS en
dc.title Combination HIV prevention among MSM in South Africa: results from agent-based modeling en
dc.type Journal Article en
dc.description.version Y en
dc.ProjectNumber N/A en
dc.Volume 9(11) en
dc.BudgetYear 2014/15 en
dc.ResearchGroup HIV/AIDS, STIs and TB en
dc.SourceTitle PLoS One en
dc.PlaceOfPublication San Francisco, USA en
dc.ArchiveNumber 8408 en
dc.URL en
dc.PageNumber Online en
dc.outputnumber 7143 en
dc.bibliographictitle Brookmeyer, R., Boren, D., Baral, S.D., Bekker, L- G., Phaswana-Mafuya, N., Beyrer, C. & Sullivan, P.S. (2014) Combination HIV prevention among MSM in South Africa: results from agent-based modeling. PLoS One. 9(11):Online. en
dc.publicationyear 2014 en
dc.contributor.author1 Brookmeyer, R. en
dc.contributor.author2 Boren, D. en
dc.contributor.author3 Baral, S.D. en
dc.contributor.author4 Bekker, L- G. en
dc.contributor.author5 Phaswana-Mafuya, N. en
dc.contributor.author6 Beyrer, C. en
dc.contributor.author7 Sullivan, P.S. en

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