Simulating HIV Transmission Dynamics and Predicting the Impact of Testing Policies in Men Who Have Sex with Men in the UK, France, and Poland

2020 ◽  
Keyword(s):  
Hiv Transmission ◽  
Transmission Dynamics ◽  
Sex With Men ◽  
The Uk ◽  
The Impact ◽  
Testing Policies

scholarly journals Development of an Agent-Based Model to Investigate the Impact of HIV Self-Testing Programs on Men Who Have Sex With Men in Atlanta and Seattle (Preprint)

2017 ◽  
Author(s):  
Wei Luo ◽  
David A Katz ◽  
Deven T Hamilton ◽  
Jennie McKenney ◽  
Samuel M Jenness ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Hiv Transmission ◽  
Transmission Dynamics ◽  
Model Parameters ◽  
Hiv Incidence ◽  
Agent Based ◽  
Self Test ◽  
Sex With Men ◽  
Living With Hiv ◽  
The Impact

BACKGROUND In the United States HIV epidemic, men who have sex with men (MSM) remain the most profoundly affected group. Prevention science is increasingly being organized around HIV testing as a launch point into an HIV prevention continuum for MSM who are not living with HIV and into an HIV care continuum for MSM who are living with HIV. An increasing HIV testing frequency among MSM might decrease future HIV infections by linking men who are living with HIV to antiretroviral care, resulting in viral suppression. Distributing HIV self-test (HIVST) kits is a strategy aimed at increasing HIV testing. Our previous modeling work suggests that the impact of HIV self-tests on transmission dynamics will depend not only on the frequency of tests and testers’ behaviors but also on the epidemiological and testing characteristics of the population. OBJECTIVE The objective of our study was to develop an agent-based model to inform public health strategies for promoting safe and effective HIV self-tests to decrease the HIV incidence among MSM in Atlanta, GA, and Seattle, WA, cities representing profoundly different epidemiological settings. METHODS We adapted and extended a network- and agent-based stochastic simulation model of HIV transmission dynamics that was developed and parameterized to investigate racial disparities in HIV prevalence among MSM in Atlanta. The extension comprised several activities: adding a new set of model parameters for Seattle MSM; adding new parameters for tester types (ie, regular, risk-based, opportunistic-only, or never testers); adding parameters for simplified pre-exposure prophylaxis uptake following negative results for HIV tests; and developing a conceptual framework for the ways in which the provision of HIV self-tests might change testing behaviors. We derived city-specific parameters from previous cohort and cross-sectional studies on MSM in Atlanta and Seattle. Each simulated population comprised 10,000 MSM and targeted HIV prevalences are equivalent to 28% and 11% in Atlanta and Seattle, respectively. RESULTS Previous studies provided sufficient data to estimate the model parameters representing nuanced HIV testing patterns and HIV self-test distribution. We calibrated the models to simulate the epidemics representing Atlanta and Seattle, including matching the expected stable HIV prevalence. The revised model facilitated the estimation of changes in 10-year HIV incidence based on counterfactual scenarios of HIV self-test distribution strategies and their impact on testing behaviors. CONCLUSIONS We demonstrated that the extension of an existing agent-based HIV transmission model was sufficient to simulate the HIV epidemics among MSM in Atlanta and Seattle, to accommodate a more nuanced depiction of HIV testing behaviors than previous models, and to serve as a platform to investigate how HIV self-tests might impact testing and HIV transmission patterns among MSM in Atlanta and Seattle. In our future studies, we will use the model to test how different HIV self-test distribution strategies might affect HIV incidence among MSM.

The impact in the UK of the Central and Eastern European HIV epidemics

2009 ◽  
Vol 137 (9) ◽  
pp. 1266-1271 ◽  
Author(s):  
V. C. DELPECH ◽  
Z. YIN ◽  
J. ABERNETHY ◽  
C. HILL ◽  
L. LOGAN ◽  
...  
Keyword(s):  
Drug Users ◽  
Hiv Transmission ◽  
Hiv Prevalence ◽  
Health Clinic ◽  
Eastern European ◽  
Hiv Epidemic ◽  
Undiagnosed Hiv ◽  
Sex With Men ◽  
The Uk ◽  
The Impact

SUMMARYDespite increasing migration, the impact of HIV epidemics from Central and Eastern Europe (C&EE) on the UK HIV epidemic remains small. C&EE-born adults comprised 1·2% of adults newly diagnosed with HIV in the UK between 2000 and 2007. Most C&EE-born women probably acquired their infection heterosexually in C&EE. In contrast, 59% of C&EE-born men reported sex with men, half of whom probably acquired their infection in the UK. Previously undiagnosed HIV prevalence in C&EE-born sexual-health-clinic attendees was low (2007, 0·5%) as was overall HIV prevalence in C&EE-born women giving birth in England (2007, <0·1%). The high proportion of men who have sex with men (MSM) suggests under-reporting of this group in C&EE HIV statistics and/or migration of MSM to the UK. In addition to reducing HIV transmission in injecting drug users, preventative efforts aimed at C&EE-born MSM both within their country of origin and the UK are required.

Computer-assisted survey of attitudes to HIV and sexually transmissible infection partner notification in HIV-positive men who have sex with men

Sexual Health ◽  
2010 ◽  
Vol 7 (4) ◽  
pp. 460 ◽  
Author(s):  
Clare L. N. Woodward ◽  
Sherie Roedling ◽  
Simon G. Edwards ◽  
Alice Armstrong ◽  
John Richens
Keyword(s):  
Hiv Transmission ◽  
Partner Notification ◽  
Hiv Positive ◽  
Computer Assisted ◽  
Hiv Status ◽  
Targeted Interventions ◽  
Sexually Transmissible Infections ◽  
Sex With Men ◽  
The Uk ◽  
Median Rating

Background: HIV infection continues to rise in men who have sex with men (MSM) in the UK. Of concern are the high rates of sexually transmissible infections (STI) among HIV-positive MSM, as this is associated with onward HIV transmission. Conventional partner notification (PN) may be limited in this group by the presence of multiple non-contactable partners and the fear of breach of HIV status. Methods: We explored attitudes to PN in HIV-positive MSM having an STI screen using a computer-assisted self interview. Results and Conclusion: Our study shows HIV+ MSM, rate conventional methods of PN highly (median rating 8/10) but are also supportive of new approaches to PN particularly anonymous email when linked to website information. They would also be open to targeted interventions such as peer recruitment.

scholarly journals The transmission dynamics of hepatitis B in the UK: a mathematical model for evaluating costs and effectiveness of immunization programmes

1996 ◽  
Vol 116 (1) ◽  
pp. 71-89 ◽  
Author(s):  
J. R. Williams ◽  
D. J. Nokes ◽  
G. F. Medley ◽  
R. M. Anderson
Keyword(s):  
Mathematical Model ◽  
Hepatitis B ◽  
Vaccine Coverage ◽  
Vaccine Dose ◽  
Transmission Dynamics ◽  
Costs And Benefits ◽  
Vaccination Strategies ◽  
The Uk ◽  
The Impact ◽  
Immunization Programmes

SummaryComplex hepatitis B (HBV) epidemiology makes it difficult to evaluate and compare effectiveness of different immunization policies. A method for doing so is presented using a mathematical model of HBV transmission dynamics which can represent universal infant and adolescent vaccination strategies and those targeted at genito-urinary (GU) clinic attenders and infants born to infectious mothers. Model structure, epidemiological underpinning, and parameterization, are described. Data from the UK National Survey of Sexual Attitudes and Lifestyles is used to define patterns of sexual activity and GU clinic attendance; data deficiencies are discussed, in particular that of UK seroprevalence of HBV markers stratified by age, sex, and risk factors. General model predictions of endemic HBV marker prevalence in homosexual and heterosexual populations seem consistent with published UK data. The simulations exhibit non-linearities in the impact of different vaccination strategies. Estimated number of carriers prevented per vaccine dose for each strategy provides a measure of costs and benefits, varying temporally over the course of a programme, and with level of vaccine coverage. Screening before vaccination markedly increases payback per dose in homosexuals but not in heterosexuals; mass infant vaccination gives the poorest effectiveness ratio and vaccination of infants after antenatal screening the best; in general, increasing vaccine coverage yields lower pay-back per dose. The model provides a useful framework for evaluating costs and benefits of immunization programmes, but for precise quantitative comparison more UK epidemiological data is urgently needed.

scholarly journals ‘Stay at home …’: exploring the impact of the COVID-19 public health response on sexual behaviour and health service use among men who have sex with men: findings from a large online survey in the UK

2021 ◽  
pp. sextrans-2021-055039
Author(s):  
Alison R Howarth ◽  
John Saunders ◽  
David Reid ◽  
Isabelle Kelly ◽  
Sonali Wayal ◽  
...  
Keyword(s):  
Public Health ◽  
Sexual Behaviour ◽  
Service Use ◽  
Health Planning ◽  
Unmet Need ◽  
Public Health Response ◽  
Sti Testing ◽  
Sex With Men ◽  
The Uk ◽  
The Impact

ObjectivesThe first UK national lockdown began on 23 March 2020, in response to the COVID-19 pandemic, and led to reduced STI/HIV service provision in the UK. We investigated sexual behaviour, use and need for sexual healthcare during the pandemic.MethodsParticipants (N=2018), including men (cis/transgender), transwomen and gender-diverse people reporting sex with another man (cis/transgender) or non-binary person assigned male at birth, completed an online cross-sectional survey (23 June 2020–14 July 2020), in response to adverts on social media and dating apps.Sexual behaviour, service use and unmet need for STI testing (any new male and/or multiple condomless anal sex (CAS) partners without STI testing) in the 3 months since lockdown began were examined and compared using multivariable analyses with an equivalent 3-month period in a 2017 survey (N=1918), conducted by the same research team.ResultsSince lockdown began, 36.7% of participants reported one or more new partners, 17.3% reported CAS with multiple partners, 29.7% HIV testing (among 1815 of unknown/negative status), 24.9% STI testing and 15.4% using pre-exposure prophylaxis (PrEP).Since lockdown began, 25.3% of participants had unmet need for STI testing. This was more likely among Asian versus white participants (adjusted OR (aOR)=1.76, (1.14 to 2.72), p=0.01); for participants living in Scotland (aOR=2.02, (1.40 to 2.91), p<0.001) or Northern Ireland (aOR=1.93, (1.02–3.63), p=0.04) versus England; and for those living with HIV (aOR=1.83, (1.32 to 2.53), p<0.001).Compared to 2017, the equivalent 2020 subsample were less likely to report new male partners (46.8% vs 71.1%, p<0.001), multiple CAS partners (20.3% vs 30.8%, p<0.001) and have unmet need for STI testing (32.8% vs 42.5%, p<0.001) in the past 3 months.ConclusionsWe found potential for ongoing STI/HIV transmission among men who have sex with men during the initial UK lockdown, despite reduced sexual activity, and inequalities in service access. These findings will support public health planning to mitigate health risks during and after the COVID-19 response.

scholarly journals Condomless sex in HIV-diagnosed men who have sex with men in the UK: prevalence, correlates, and implications for HIV transmission

2017 ◽  
Vol 93 (8) ◽  
pp. 590-598 ◽  
Author(s):  
Marina Daskalopoulou ◽  
Alison J Rodger ◽  
Andrew N Phillips ◽  
Lorraine Sherr ◽  
Jonathan Elford ◽  
...  
Keyword(s):  
Hiv Transmission ◽  
Condomless Sex ◽  
Sex With Men ◽  
The Uk

scholarly journals Modelling the impact of an HIV testing intervention on HIV transmission among men who have sex with men in China

HIV Medicine ◽  
2021 ◽  
Author(s):  
Ross D. Booton ◽  
Jason J. Ong ◽  
Amy Lee ◽  
Aifeng Liu ◽  
Wenting Huang ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Hiv Transmission ◽  
Sex With Men ◽  
The Impact

High incidence of extra-genital gonorrheal and chlamydial infections among high-risk men who have sex with men and transgender women in Peru

2017 ◽  
Vol 29 (6) ◽  
pp. 568-576 ◽  
Author(s):  
Lao-Tzu Allan-Blitz ◽  
Kelika A Konda ◽  
Gino M Calvo ◽  
Silver K Vargas ◽  
Segundo R Leon ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Hiv Transmission ◽  
Incidence Rates ◽  
Transgender Women ◽  
Adjusted Incidence Rate ◽  
Sex With Men ◽  
Hiv Acquisition ◽  
Rate Ratios ◽  
Incident Cases ◽  
The Impact

Extra-genital Neisseria gonorrhoeae and Chlamydia trachomatis infections are associated with antimicrobial resistance and HIV acquisition. We analyzed data from a cohort of men who have sex with men (MSM) and transgender women followed quarterly for two years in Peru. Incident cases were defined as positive N. gonorrhoeae or C. trachomatis nucleic acid tests during follow-up. Repeat positive tests were defined as reinfection among those with documented treatment. We used generalized estimating equations to calculate adjusted incidence rate ratios (aIRRs). Of 404 participants, 22% were transgender. Incidence rates of rectal N. gonorrhoeae and C. trachomatis infection were 28.1 and 37.3 cases per 100 person-years, respectively. Incidence rates of pharyngeal N. gonorrhoeae and C. trachomatis infection were 21.3 and 9.6 cases per 100 person-years, respectively. Incident HIV infection was associated with incident rectal (aIRR = 2.43; 95% CI 1.66–3.55) N. gonorrhoeae infection. Identifying as transgender versus cisgender MSM was associated with incident pharyngeal N. gonorrhoeae (aIRR = 1.85; 95% CI 1.12–3.07) infection. The incidence of extra-genital N. gonorrhoeae and C. trachomatis infections was high in our population. The association with incident HIV infection warrants evaluating the impact of rectal N. gonorrhoeae screening and treatment on HIV transmission.

scholarly journals Likely impact of pre-exposure prophylaxis on HIV epidemics among men who have sex with men

Sexual Health ◽  
2017 ◽  
Vol 14 (1) ◽  
pp. 97 ◽  
Author(s):  
Iryna B. Zablotska
Keyword(s):  
Hiv Transmission ◽  
Population Level ◽  
Combination Prevention ◽  
The Us ◽  
Implementation Studies ◽  
Prep Implementation ◽  
Modelling Studies ◽  
Sex With Men ◽  
Exposure Prophylaxis ◽  
The Impact

Rapid developments in the field of HIV pre-exposure prophylaxis (PrEP) with antiretrovirals offer a promise to bring HIV transmission among gay and other men who have sex with men (MSM) to zero by 2030. This review evaluates studies, which modelled the impact of PrEP on HIV diagnoses, and discusses the progress towards PrEP implementation. Studies in English, conducted after 2010 among MSM in countries of the Organization for Economic Cooperation and Development (OECD) were reviewed. Six modelling studies were included, three of which had been conducted outside the US. None of the published models showed that PrEP alone can reduce HIV diagnoses to zero and eliminate HIV transmission by 2030. However, PrEP in combination with other biomedical interventions can reduce HIV diagnoses on the population level by ~95%. Other upcoming biomedical prevention strategies may strengthen combination prevention. Access to PrEP remains limited, even in the OECD countries. Modelling studies can assist governments with decision-making about PrEP implementation and add urgency to the implementation of PrEP. More work is needed on modelling of the impact of PrEP on HIV diagnoses trends outside the US where PrEP implementation is in its early stages.

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