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{Mishra:2021:10.1002/jia2.25739,
author = {Mishra, S and Silhol, R and Knight, J and PhaswanaMafuya, R and Diouf, D and Wang, L and Schwartz, S and Boily, M and Baral, S},
doi = {10.1002/jia2.25739},
journal = {Journal of the International AIDS Society},
pages = {1--6},
title = {Estimating the epidemic consequences of HIV prevention gaps among key populations},
url = {http://dx.doi.org/10.1002/jia2.25739},
volume = {24},
year = {2021}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - IntroductionHIV epidemic appraisals are used to characterize heterogeneity and inequities in the context of the HIV pandemic and the response. However, classic measures used in appraisals have been shown to underestimate disproportionate risks of onward transmission, particularly among key populations. In response, a growing number of modelling studies have quantified the consequences of unmet prevention and treatment needs (prevention gaps) among key populations as a transmission population attributable fraction over time (tPAFt). To aid its interpretation and use by programme implementers and policy makers, we outline and discuss a conceptual framework for understanding and estimating the tPAFt via transmission modelling as a measure of onward transmission risk from HIV prevention gaps; and discuss properties of the tPAFt.DiscussionThe distribution of onward transmission risks may be defined by who is at disproportionate risk of onward transmission, and under which conditions. The latter reflects prevention gaps, including secondary prevention via treatment: the epidemic consequences of which may be quantified by the tPAFt. Steps to estimating the tPAFt include parameterizing the acquisition and onward transmission risks experienced by the subgroup of interest, defining the most relevant counterfactual scenario, and articulating the time-horizon of analyses and population among whom to estimate the relative difference in cumulative transmissions; such steps could reflect programme-relevant questions about onward transmission risks. Key properties of the tPAFt include larger onward transmission risks over longer time-horizons; seemingly mutually exclusive tPAFt measures summing to greater than 100%; an opportunity to quantify the magnitude of disproportionate onward transmission risks with a per-capita tPAFt; and that estimates are conditional on what has been achieved so far in reducing prevention gaps and maintaining those conditions moving forward as the status
AU  - Mishra,S
AU  - Silhol,R
AU  - Knight,J
AU  - PhaswanaMafuya,R
AU  - Diouf,D
AU  - Wang,L
AU  - Schwartz,S
AU  - Boily,M
AU  - Baral,S
DO  - 10.1002/jia2.25739
EP  - 6
PY  - 2021///
SN  - 1758-2652
SP  - 1
TI  - Estimating the epidemic consequences of HIV prevention gaps among key populations
T2  - Journal of the International AIDS Society
UR  - http://dx.doi.org/10.1002/jia2.25739
UR  - https://onlinelibrary.wiley.com/doi/10.1002/jia2.25739
UR  - http://hdl.handle.net/10044/1/90053
VL  - 24
ER  -
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