Imperial College London
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DrBrittaJewell

Faculty of Medicine, School of Public Health

Visiting Researcher
 
 
 
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Contact

 

b.jewell

 
 
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Location

 

28Norfolk PlaceSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Cremin:2015:10.7448/IAS.18.4.19946,
author = {Cremin, I and Morales, F and Jewell, BL and O'Reilly, KR and Hallett, TB},
doi = {10.7448/IAS.18.4.19946},
journal = {Journal of the International AIDS Society},
title = {Seasonal PrEP for partners of migrant miners in southern Mozambique: a highly focused PrEP intervention},
url = {http://dx.doi.org/10.7448/IAS.18.4.19946},
volume = {18},
year = {2015}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Introduction: To be used most effectively, pre-exposure prophylaxis (PrEP) should be prioritized to those at high risk of acquisition and would ideally be aligned with time periods of increased exposure. Identifying such time periods is not always straightforward, however. Gaza Province in southern Mozambique is characterized by high levels of HIV transmission and circular labour migration to mines in South Africa. A strong seasonal pattern in births is observable, reflecting an increase in conception in December. Given the potential for increased HIV transmission between miners returning in December and their partners in Gaza Province, PrEP use by the latter would be a useful means of HIV prevention, especially for couples who wish to conceive.Methods: A mathematical model was used to represent population-level adult heterosexual HIV transmission in Gaza Province. Increased HIV acquisition among partners of miners in December, coinciding with the miners’ return from South Africa, is represented. In addition to a PrEP intervention, the scale-up of treatment and recent scale-up of male circumcision that have occurred in Gaza are represented.Results: Providing time-limited PrEP to the partners of migrant miners, as opposed to providing PrEP all year, would improve the cost per infection averted by 7.5-fold. For the cost per infection averted to be below US$3000, at least 85% of PrEP users would need to be good adherers and PrEP would need to be cheaper than US$115 per person per year. Uncertainty regarding incidence of HIV transmission among partners of miners each year in December has a strong influence on estimates of cost per infection averted.Conclusions: Providing time-limited PrEP to partners of migrant miners in Gaza Province during periods of increased exposure would be a novel strategy for providing PrEP. This strategy would allow for a better prioritized intervention, with the potential to improve the efficiency of a PrEP intervention considerably, as
AU  - Cremin,I
AU  - Morales,F
AU  - Jewell,BL
AU  - O'Reilly,KR
AU  - Hallett,TB
DO  - 10.7448/IAS.18.4.19946
PY  - 2015///
SN  - 1758-2652
TI  - Seasonal PrEP for partners of migrant miners in southern Mozambique: a highly focused PrEP intervention
T2  - Journal of the International AIDS Society
UR  - http://dx.doi.org/10.7448/IAS.18.4.19946
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000358675400003&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - http://hdl.handle.net/10044/1/43320
VL  - 18
ER  -
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