Publications des scientifiques de l'IRD

Blaizot S., Maman D., Riche B., Mukui I., Kirubi B., Ecochard R., Etard Jean-François. (2016). Potential impact of multiple interventions on HIV incidence in a hyperendemic region in Western Kenya : a modelling study. BMC Infectious Diseases, 16, p. art. 189 [10 p.]. ISSN 1471-2334.

Titre du document
Potential impact of multiple interventions on HIV incidence in a hyperendemic region in Western Kenya : a modelling study
Année de publication
2016
Type de document
Article référencé dans le Web of Science WOS:000375080700001
Auteurs
Blaizot S., Maman D., Riche B., Mukui I., Kirubi B., Ecochard R., Etard Jean-François
Source
BMC Infectious Diseases, 2016, 16, p. art. 189 [10 p.] ISSN 1471-2334
Background: Multiple prevention interventions, including early antiretroviral therapy initiation, may reduce HIV incidence in hyperendemic settings. Our aim was to predict the short-term impact of various single and combined interventions on HIV spreading in the adult population of Ndhiwa subcounty (Nyanza Province, Kenya). Methods: A mathematical model was used with data on adults (15-59 years) from the Ndhiwa HIV Impact in Population Survey to compare the impacts on HIV prevalence, HIV incidence rate, and population viral load suppression of various interventions. These interventions included: improving the cascade of care (use of three guidelines), increasing voluntary medical male circumcision (VMMC), and implementing pre-exposure prophylaxis (PrEP) use among HIV-uninfected women. Results: After four years, improving separately the cascade of care under the WHO 2013 guidelines and under the treat-all strategy would reduce the overall HIV incidence rate by 46 and 58 %, respectively, vs. the baseline rate, and by 35 and 49 %, respectively, vs. the implementation of the current Kenyan guidelines. With conservative and optimistic scenarios, VMMC and PrEP would reduce the HIV incidence rate by 15-25 % and 22-28 % vs. the baseline, respectively. Combining the WHO 2013 guidelines with VMMC would reduce the HIV incidence rate by 35-56 % and combining the treat-all strategy with VMMC would reduce it by 49-65 %. Combining the WHO 2013 guidelines, VMMC, and PrEP would reduce the HIV incidence rate by 46-67 %. Conclusions: The impacts of the WHO 2013 guidelines and the treat-all strategy were relatively close; their implementation is desirable to reduce HIV spread. Combining several strategies is promising in adult populations of hyperendemic areas but requires regular, reliable, and costly monitoring.
Plan de classement
Sciences fondamentales / Techniques d'analyse et de recherche [020] ; Entomologie médicale / Parasitologie / Virologie [052] ; Santé : aspects socioculturels, économiques et politiques [056]
Description Géographique
KENYA
Localisation
Fonds IRD [F B010066834]
Identifiant IRD
fdi:010066834
Contact