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{Stone:2021:10.1002/jia2.25650,
author = {Stone, J and Mukandavire, C and Boily, M-C and Fraser, H and Mishra, S and Schwartz, S and Rao, A and Looker, KJ and Quaife, M and Terris-Prestholt, F and Marr, A and Lane, T and Coetzee, J and Gray, G and Otwombe, K and Milovanovic, M and Hausler, H and Young, K and Mcingana, M and Ncedani, M and Puren, A and Hunt, G and Kose, Z and Phaswana-Mafuya, N and Baral, S and Vickerman, P},
doi = {10.1002/jia2.25650},
journal = {Journal of the International AIDS Society},
title = {Estimating the contribution of key populations towards HIV transmission in South Africa},
url = {http://dx.doi.org/10.1002/jia2.25650},
volume = {24},
year = {2021}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - INTRODUCTION: In generalized epidemic settings, there is insufficient understanding of how the unmet HIV prevention and treatment needs of key populations (KPs), such as female sex workers (FSWs) and men who have sex with men (MSM), contribute to HIV transmission. In such settings, it is typically assumed that HIV transmission is driven by the general population. We estimated the contribution of commercial sex, sex between men, and other heterosexual partnerships to HIV transmission in South Africa (SA). METHODS: We developed the "Key-Pop Model"; a dynamic transmission model of HIV among FSWs, their clients, MSM, and the broader population in SA. The model was parameterized and calibrated using demographic, behavioural and epidemiological data from national household surveys and KP surveys. We estimated the contribution of commercial sex, sex between men and sex among heterosexual partnerships of different sub-groups to HIV transmission over 2010 to 2019. We also estimated the efficiency (HIV infections averted per person-year of intervention) and prevented fraction (% IA) over 10-years from scaling-up ART (to 81% coverage) in different sub-populations from 2020. RESULTS: Sex between FSWs and their paying clients, and between clients with their non-paying partners contributed 6.9% (95% credibility interval 4.5% to 9.3%) and 41.9% (35.1% to 53.2%) of new HIV infections in SA over 2010 to 2019 respectively. Sex between low-risk groups contributed 59.7% (47.6% to 68.5%), sex between men contributed 5.3% (2.3% to 14.1%) and sex between MSM and their female partners contributed 3.7% (1.6% to 9.8%). Going forward, the largest population-level impact on HIV transmission can be achieved from scaling up ART to clients of FSWs (% IA = 18.2% (14.0% to 24.4%) or low-risk individuals (% IA = 20.6% (14.7 to 27.5) over 2020 to 2030), with ART scale-up among KPs being most efficient. CONCLUSIONS: Clients of FSWs play a fundamental role in HIV transmiss
AU  - Stone,J
AU  - Mukandavire,C
AU  - Boily,M-C
AU  - Fraser,H
AU  - Mishra,S
AU  - Schwartz,S
AU  - Rao,A
AU  - Looker,KJ
AU  - Quaife,M
AU  - Terris-Prestholt,F
AU  - Marr,A
AU  - Lane,T
AU  - Coetzee,J
AU  - Gray,G
AU  - Otwombe,K
AU  - Milovanovic,M
AU  - Hausler,H
AU  - Young,K
AU  - Mcingana,M
AU  - Ncedani,M
AU  - Puren,A
AU  - Hunt,G
AU  - Kose,Z
AU  - Phaswana-Mafuya,N
AU  - Baral,S
AU  - Vickerman,P
DO  - 10.1002/jia2.25650
PY  - 2021///
SN  - 1758-2652
TI  - Estimating the contribution of key populations towards HIV transmission in South Africa
T2  - Journal of the International AIDS Society
UR  - http://dx.doi.org/10.1002/jia2.25650
UR  - https://www.ncbi.nlm.nih.gov/pubmed/33533115
UR  - http://hdl.handle.net/10044/1/86042
VL  - 24
ER  -
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