Imperial College London
Alternate

ProfessorMarie-ClaudeBoily

Faculty of Medicine, School of Public Health

Professor of Mathematical Epidemiology
 
 
 
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Contact

 

+44 (0)20 7594 3263mc.boily

 
 
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Location

 

LG26Norfolk PlaceSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Silhol:2021:10.1097/QAI.0000000000002580,
author = {Silhol, R and Baral, S and Bowring, A and Mukandavire, C and Mfochive, Njindam I and Rao, A and Schwartz, S and Tamoufe, U and Billong, S and Njoya, O and Zoung-Kanyi, Bissek A-C and Garcia, Calleja JM and Vickerman, P and Mishra, S and Boily, M-C},
doi = {10.1097/QAI.0000000000002580},
journal = {JAIDS: Journal of Acquired Immune Deficiency Syndromes},
pages = {396--405},
title = {Quantifying the evolving contribution of HIV interventions and key populations to the HIV epidemic in Yaoundé, Cameroon},
url = {http://dx.doi.org/10.1097/QAI.0000000000002580},
volume = {86},
year = {2021}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background: Key populations (KP) including men who have sex with men (MSM), female sex workers (FSW), and their clients are disproportionately affected by HIV in Sub-Saharan Africa. We estimated the evolving impact of past interventions and contribution of unmet HIV prevention/treatment needs of KP and lower-risk groups to HIV transmission.Setting: Yaoundé, Cameroon.Methods: We parametrised and fitted a deterministic of HIV transmission model to Yaoundé-specific demographic, behavioural, HIV and intervention coverage data in a Bayesian framework. We estimated the fraction of incident HIV infections averted by condoms and antiretroviral therapy (ART) and the fraction of all infections over 10-year periods directly and indirectly attributable to unprotected sex within and between each risk group.Results: Condom use and ART together may have averted 43% (95% uncertainty interval: 31-54) of incident infections over 1980-2018 and 72% (66-79) over 2009-2018. Most onward transmissions over 2009-2018 stemmed from unprotected sex between lower-risk individuals (47% (32-61)), clients (37% (23-51)), and MSM (35% (20-54)) with all their partners. The contribution of commercial sex decreased from 25% (8-49) over 1989-1998 to 8% (3-22) over 2009-2018, due to higher intervention coverage among FSW.Conclusion: Condom use and recent ART scale-up mitigated the HIV epidemic in Yaoundé and changed the contribution of different partnerships to onward transmission over time. Findings highlight the importance of prioritizing HIV prevention and treatment for MSM and clients of FSW whose unmet needs now contribute most to onward transmission, while maintaining services which successfully reduced transmissions in the context of commercial sex.
AU  - Silhol,R
AU  - Baral,S
AU  - Bowring,A
AU  - Mukandavire,C
AU  - Mfochive,Njindam I
AU  - Rao,A
AU  - Schwartz,S
AU  - Tamoufe,U
AU  - Billong,S
AU  - Njoya,O
AU  - Zoung-Kanyi,Bissek A-C
AU  - Garcia,Calleja JM
AU  - Vickerman,P
AU  - Mishra,S
AU  - Boily,M-C
DO  - 10.1097/QAI.0000000000002580
EP  - 405
PY  - 2021///
SN  - 1525-4135
SP  - 396
TI  - Quantifying the evolving contribution of HIV interventions and key populations to the HIV epidemic in Yaoundé, Cameroon
T2  - JAIDS: Journal of Acquired Immune Deficiency Syndromes
UR  - http://dx.doi.org/10.1097/QAI.0000000000002580
UR  - https://journals.lww.com/jaids/Abstract/9000/Quantifying_the_evolving_contribution_of_HIV.96008.aspx
UR  - http://hdl.handle.net/10044/1/85019
VL  - 86
ER  -
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