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{Dimitrov:2010:10.2202/1948-4690.1012,
author = {Dimitrov, DT and Masse, B and Boily, M-C},
doi = {10.2202/1948-4690.1012},
journal = {Stat Commun Infect Dis},
title = {Who will Benefit from a Wide-Scale Introduction of Vaginal Microbicides in Developing Countries?},
url = {http://dx.doi.org/10.2202/1948-4690.1012},
volume = {2},
year = {2010}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Vaginal microbicides (VMB) are currently among the few biomedical interventions designed to help women reduce their risk of acquiring HIV infection. However, the microbicide containing antiretroviral (ARV-VMB) may lead to the development of antiretroviral resistance and could paradoxically become more beneficial to men at the population level. We developed a mathematical model to study the impact of a wide-scale population usage of VMB in a heterosexual population. Gender ratios of prevented infections and prevalence reduction are evaluated in 63 different intervention schedules including continuous and interrupted ARV-VMB use by HIV-positive women. The influence of different factors on population-level benefits is also studied through Monte Carlo simulations using parameters sampled from primary ranges representative of developing countries. Our analysis indicates that women are more likely than men to benefit from ARV-VMB use since 78-80% of the total 63,000 simulations investigated (under different parameter sets) showed a female advantage whether benefit is measured as cumulative number of infections prevented, the percentage of cumulative infections prevented, or the expected reduction in prevalence. Stratified analysis by scenarios indicates that the likelihood of a male advantage with respect to the fractions of prevented infections varies from 6% to 49% among the scenarios. It is substantial only if the risk of systemic absorption and development of resistance to ARV-VMB is high and the HIV-positive women use VMB indefinitely without interruption. Therefore, the use of ARV-VMB, with successful control measures restricting usage by HIV-positive women, is still very much a female prevention tool.
AU  - Dimitrov,DT
AU  - Masse,B
AU  - Boily,M-C
DO  - 10.2202/1948-4690.1012
PY  - 2010///
SN  - 2194-6310
TI  - Who will Benefit from a Wide-Scale Introduction of Vaginal Microbicides in Developing Countries?
T2  - Stat Commun Infect Dis
UR  - http://dx.doi.org/10.2202/1948-4690.1012
UR  - https://www.ncbi.nlm.nih.gov/pubmed/24490001
VL  - 2
ER  -
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