The impact of past HIV interventions and diagnosis gaps on new HIV acquisitions, transmissions, and HIV-related deaths in Cote d'Ivoire, Mali, and Senegal

2024

Article référencé dans le Web of Science WOS:001301025900010

Silhol R., Maheu-Giroux M., Soni N., Fotso A. S., Rouveau N., Vautier A., Doumenc-Aïdara C., Geoffroy O., N'Guessan K. N., Sidibé Y., Kabemba O. K., Gueye P. A., Ndeye P. D., Mukandavire C., Vickerman P., Keita A., Ndour C. T., Ehui E., Larmarange Joseph, Boily M. C.

AIDS, 2024, 38 (12), 1783-1793 ISSN 0269-9370

Objectives: To estimate the epidemiological impact of past HIV interventions and the magnitude and contribution of undiagnosed HIV among different risk groups on new HIV acquisitions in Cote d'Ivoire, Mali and Senegal. Design: HIV transmission dynamic models among the overall population and key populations [female sex workers (FSW), their clients, and MSM]. Methods: Models were independently parameterized and calibrated for each set of country-specific demographic, behavioural, and epidemiological data. We estimated the fraction of new HIV infections over 2012-2021 averted by condom use and antiretroviral therapy (ART) uptake among key populations and non-key populations, the direct and indirect contribution of specific groups to new infections [transmission population-attributable fraction (tPAF)] over 2012-2021 due to prevention gaps, and the distribution of undiagnosed people with HIV (PWH) by risk group in January 2022 and their tPAF over 2022-2031. Results: Condom use and ART may have averted 81-88% of new HIV infections over 2012-2021 across countries, mostly due to condom use by key population. The tPAF of all key populations combined over 2012-2021 varied between 27% (C & ocirc;te d'Ivoire) and 79% (Senegal). Male key populations (clients of FSW and MSM) contributed most to new infections (>60% in Mali and Senegal) owing to their higher HIV prevalence and larger prevention gaps. In 2022, men represented 56% of all PWH with an undiagnosed infection in Cote d'Ivoire (male key populations = 15%), 46% in Mali (male key populations = 23%), and 69% in Senegal (male key populations = 55%). If HIV testing and ART initiation rates remain at current levels, 20% of new HIV infections could be due to undiagnosed key populations living with HIV in C & ocirc;te d'Ivoire over 2022-2031, 53% in Mali, and 65% in Senegal. Conclusion: Substantial HIV diagnosis gaps remain in Western Africa, especially among male key populations. Addressing these gaps is key to impacting the HIV epidemics in the region and achieving the goal of ending AIDS by 2030.

Entomologie médicale / Parasitologie / Virologie [052] ; Santé : aspects socioculturels, économiques et politiques [056]

MALI ; SENEGAL

Fonds IRD [F B010091272]

fdi:010091272