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{Maheu-Giroux:2017:10.1097/QAI.0000000000001434,
author = {Maheu-Giroux, M and Vesga, JF and Diabate, S and Alary, M and Baral, S and Boily, M and Diouf, D and Abo, K},
doi = {10.1097/QAI.0000000000001434},
journal = {JAIDS - Journal of Acquired Immune Deficiency Syndromes},
pages = {517--527},
title = {Changing dynamics of HIV transmission in Côte d'Ivoire: modeling which key populations acquired and transmitted infections and estimating the impact of past HIV interventions (1976-2015)},
url = {http://dx.doi.org/10.1097/QAI.0000000000001434},
volume = {75},
year = {2017}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Introduction: Understanding the impact of past interventions and how it affected transmission dynamics is key to guiding prevention efforts. We estimated the population-level impact of condom, antiretroviral therapy (ART), and prevention of mother-to-child transmission activities on HIV transmission and the contribution of key risk factors on HIV acquisition and transmission. Methods: An age stratified dynamical model of sexual and vertical HIV transmission among the general population, female sex workers (FSW), and men who have sex with men (MSM) was calibrated to detailed prevalence and intervention data. We estimated the fraction of HIV infections averted by the interventions, and the fraction of incident infections acquired and transmitted by different populations over successive 10-year periods (1976-2015). Results: Overall, condom use averted 61% (95% Credible Intervals: 56-66%) of all adult infections during 1987-2015 mainly due to increases by FSW (46% of infections averted). In comparison, ART prevented 15% (10-19%) of adult infections during 2010- 2015. As a result, FSW initially (1976-1985) contributed 95% (91-97%) of all new infections, declining to 19% (11-27%) during 2005-2015. Older men and clients mixing with non-FSW are currently the highest contributor to transmission. MSM contributed ≤4% transmissions throughout. Young women (15-24 years; excluding FSW) do not transmit more infection than they acquired. Conclusion: Early increases in condom use, mainly by FSW, have substantially reduced HIV transmission. Clients of FSW and older men have become the main source of transmission whereas young women remain at increased risk. Strengthening prevention and scaling-up of ART, particularly to FSW and CFSW, is important.
AU  - Maheu-Giroux,M
AU  - Vesga,JF
AU  - Diabate,S
AU  - Alary,M
AU  - Baral,S
AU  - Boily,M
AU  - Diouf,D
AU  - Abo,K
DO  - 10.1097/QAI.0000000000001434
EP  - 527
PY  - 2017///
SN  - 1525-4135
SP  - 517
TI  - Changing dynamics of HIV transmission in Côte d'Ivoire: modeling which key populations acquired and transmitted infections and estimating the impact of past HIV interventions (1976-2015)
T2  - JAIDS - Journal of Acquired Immune Deficiency Syndromes
UR  - http://dx.doi.org/10.1097/QAI.0000000000001434
UR  - http://hdl.handle.net/10044/1/48107
VL  - 75
ER  -
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