Imperial College London


Faculty of MedicineSchool of Public Health

Professor of Mathematical Epidemiology



+44 (0)20 7594 3263mc.boily




LG26Norfolk PlaceSt Mary's Campus






BibTex format

author = {Mukandavire, C and Walker, J and Schwartz, S and Boily, MC and Marie-Claude, B and Leon, D and Carrie, L and Daouda, D and Ben, L and Nafissatou, Leye D and Fatou, D and Karleen, C and Remy, Serge MM and Safiatou, T and Papa, Amadou Niang D and Coumba, T and Cheikh, N and Erik, V and Sharmistha, M and Stefan, B and Peter, V},
doi = {10.1002/jia2.25126},
journal = {Journal of the International AIDS Society},
title = {Estimating the contribution of key populations towards spread of HIV in Dakar, Senegal},
url = {},
volume = {21},
year = {2018}

RIS format (EndNote, RefMan)

AB - IntroductionKey populations including female sex workers (FSW) and men who have sex with men (MSM) bear a disproportionate burden of HIV. However, the role of focusing prevention efforts on these groups for reducing a country’s HIV epidemic is debated. We estimate the extent to which HIV transmission amongst FSW and MSM contributes to overall HIV transmission in Dakar, Senegal, using a dynamic assessment of the population attributable fraction (PAF).MethodsA dynamic transmission model of HIV among FSW, their clients, MSM and the lower-risk adult population was parameterized and calibrated within a Bayesian framework using setting-specific demographic, behavioural, HIV epidemiological, and antiretroviral treatment (ART) coverage data for 1985-2015. We used the model to estimate the 10-year PAF of commercial sex between FSW and their clients, and sex between men, to overall HIV transmission (defined as the percentage of new infections prevented when these modes of transmission are removed). Additionally, we estimated the prevention benefits associated with historical increases in condom use and ART uptake, and impact of further increases in prevention and treatment.ResultsThe model projections suggest that unprotected sex between men contributed to 42% (2.5 to 97.5th percentile range 24-59%) of transmissions between 1995-2005, increasing to 64% (37-79%) from 2015-2025. The 10-year PAF of commercial sex is smaller, diminishing from 21% (7-39%) in 1995 to 14% (5-35%) in 2015. Without ART, 49% (32-71%) more HIV infections would have occurred since 2000, when ART was initiated, whereas without condom use since 1985, 67% (27-179%) more HIV infections would have occurred, and the overall HIV prevalence would have been 60% (29-211%) greater than what it is now. Further large decreases in HIV incidence (68%) can be achieved by scaling up ART in MSM to 74% coverage and reducing their susceptibility to HIV by a two-thirds through any prevention modality.ConclusionsUnprote
AU - Mukandavire,C
AU - Walker,J
AU - Schwartz,S
AU - Boily,MC
AU - Marie-Claude,B
AU - Leon,D
AU - Carrie,L
AU - Daouda,D
AU - Ben,L
AU - Nafissatou,Leye D
AU - Fatou,D
AU - Karleen,C
AU - Remy,Serge MM
AU - Safiatou,T
AU - Papa,Amadou Niang D
AU - Coumba,T
AU - Cheikh,N
AU - Erik,V
AU - Sharmistha,M
AU - Stefan,B
AU - Peter,V
DO - 10.1002/jia2.25126
PY - 2018///
SN - 1758-2652
TI - Estimating the contribution of key populations towards spread of HIV in Dakar, Senegal
T2 - Journal of the International AIDS Society
UR -
UR -
VL - 21
ER -