@article{fdi:010066834,
  title = {{P}otential impact of multiple interventions on {HIV} incidence in a hyperendemic region in {W}estern {K}enya : a modelling study},
  author = {{B}laizot, {S}. and {M}aman, {D}. and {R}iche, {B}. and {M}ukui, {I}. and {K}irubi, {B}. and {E}cochard, {R}. and {E}tard, {J}ean-{F}ran{\c{c}}ois},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground: {M}ultiple prevention interventions, including early antiretroviral therapy initiation, may reduce {HIV} incidence in hyperendemic settings. {O}ur aim was to predict the short-term impact of various single and combined interventions on {HIV} spreading in the adult population of {N}dhiwa subcounty ({N}yanza {P}rovince, {K}enya). {M}ethods: {A} mathematical model was used with data on adults (15-59 years) from the {N}dhiwa {HIV} {I}mpact in {P}opulation {S}urvey to compare the impacts on {HIV} prevalence, {HIV} incidence rate, and population viral load suppression of various interventions. {T}hese interventions included: improving the cascade of care (use of three guidelines), increasing voluntary medical male circumcision ({VMMC}), and implementing pre-exposure prophylaxis ({P}r{EP}) use among {HIV}-uninfected women. {R}esults: {A}fter 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 {K}enyan guidelines. {W}ith conservative and optimistic scenarios, {VMMC} and {P}r{EP} would reduce the {HIV} incidence rate by 15-25 % and 22-28 % vs. the baseline, respectively. {C}ombining 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 %. {C}ombining the {WHO} 2013 guidelines, {VMMC}, and {P}r{EP} would reduce the {HIV} incidence rate by 46-67 %. {C}onclusions: {T}he impacts of the {WHO} 2013 guidelines and the treat-all strategy were relatively close; their implementation is desirable to reduce {HIV} spread. {C}ombining several strategies is promising in adult populations of hyperendemic areas but requires regular, reliable, and costly monitoring.},
  keywords = {{HIV} ; {H}yperendemic settings ; {M}athematical models ; {A}ntiretroviral therapy ; {M}ale circumcision ; {P}re-exposure prophylaxis ; {KENYA}},
  booktitle = {},
  journal = {{BMC} {I}nfectious {D}iseases},
  volume = {16},
  numero = {},
  pages = {art. 189 [10 p.]},
  ISSN = {1471-2334},
  year = {2016},
  DOI = {10.1186/s12879-016-1520-4},
  URL = {https://www.documentation.ird.fr/hor/fdi:010066834},
}