Understanding the HIV epidemic among MSM in Baltimore: a modelling study estimating the impact of past HIV interventions and who acquired and contributed to infections.
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Published version
Author(s)
Type
Journal Article
Abstract
INTRODUCTION: Men who have sex with men (MSM) in the United States (US) are disproportionately affected by HIV. We estimated the impact of past interventions and contribution of different population groups to incident MSM HIV infections. SETTING: Baltimore, US METHODS:: We used a deterministic model, parameterised and calibrated to demographic and epidemic Baltimore MSM data, to estimate the fraction of HIV infections among MSM averted by condoms and antiretroviral therapy (ART) over 1984-2017 and the fraction of infections acquired and transmission contributed by MSM from different demographic groups and disease and care continuum stages over 10-year periods from 1988 to 2017, using population attributable fractions (PAFs). RESULTS: Condom use and ART averted 19% (95% uncertainty interval: 14-25%) and 23% (15-31%) of HIV infections that would have occurred since 1984 and 1996, respectively. Over 2008-2017, 46% (41-52%) of incident infections were acquired by, and 35% (27-49%) of transmissions contributed by MSM aged 18-24 years old (who constitute 27% of all MSM, 19% of HIV+ MSM). MSM with undiagnosed HIV infection, those with diagnosed infection but not in care, and those on ART contributed to 41% (31-54%), 46% (25-56%), and 14% (7-28%) of transmissions, respectively. CONCLUSION: Condoms and ART have modestly impacted the HIV epidemic among Baltimore MSM to date. Interventions reaching MSM with diagnosed infection who are not in care should be implemented since the largest percentage of HIV transmissions among Baltimore MSM are attributed to this group.
Date Issued
2020-07-01
Date Acceptance
2020-02-12
Citation
JAIDS: Journal of Acquired Immune Deficiency Syndromes, 2020, 84 (3), pp.253-262
ISSN
1525-4135
Publisher
Lippincott, Williams & Wilkins
Start Page
253
End Page
262
Journal / Book Title
JAIDS: Journal of Acquired Immune Deficiency Syndromes
Volume
84
Issue
3
Copyright Statement
© 2020 The Author(s). Published by Wolters Kluwer Health, Inc. This is an open-access article distributed under the terms of the Creative Commons
Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is
properly cited. The work cannot be used commercially without permission from the journal.
Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is
properly cited. The work cannot be used commercially without permission from the journal.
Sponsor
National Institutes of Health
National Institutes of Health
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/32141958
Grant Number
UM1AI068617 Sub#0000925919
0000874378
Subjects
1103 Clinical Sciences
1117 Public Health and Health Services
Virology
Publication Status
Published online
Coverage Spatial
United States
Date Publish Online
2020-07-01