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Quantifying the Evolving Contribution of HIV Interventions and Key Populations to the HIV Epidemic in Yaoundé, Cameroon.

Authors :
Silhol, Romain
Baral, Stefan
Bowring, Anna L.
Mukandavire, Christinah
Njindam, Iliassou M.
Rao, Amrita
Schwartz, Sheree
Tamoufe, Ubald
Billong, Serge C.
Njoya, Oudou
Zoung-Kanyi Bissek, Anne-Cecile
Calleja, Jesus M. G.
Vickerman, Peter
Mishra, Sharmistha
Boily, Marie-Claude
Source :
JAIDS: Journal of Acquired Immune Deficiency Syndromes. Apr2021, Vol. 86 Issue 4, p396-405. 10p.
Publication Year :
2021

Abstract

Background: Key populations (KP) including men who have sex with men (MSM), female sex workers (FSW), and their clients are disproportionately affected by HIV in Sub-Saharan Africa. We estimated the evolving impact of past interventions and contribution of unmet HIV prevention/treatment needs of key populations and lower-risk groups to HIV transmission. Setting: Yaoundé, Cameroon. Methods: We parametrized and fitted a deterministic HIV transmission model to Yaoundé-specific demographic, behavioral, HIV, and intervention coverage data in a Bayesian framework. We estimated the fraction of incident HIV infections averted by condoms and antiretroviral therapy (ART) and the fraction of all infections over 10-year periods directly and indirectly attributable to sex within and between each risk group. Results: Condom use and ART together may have averted 43% (95% uncertainty interval: 31--54) of incident infections over 1980--2018 and 72% (66--79) over 2009--2018. Most onward transmissions over 2009--2018 stemmed from sex between lower-risk individuals [47% (32--61)], clients [37% (23--51)], and MSM [35% (20--54)] with all their partners. The contribution of commercial sex decreased from 25% (8--49) over 1989--1998 to 8% (3--22) over 2009--2018, due to higher intervention coverage among FSW. Conclusion: Condom use and recent ART scale-up mitigated the HIV epidemic in Yaoundé and changed the contribution of different partnerships to onward transmission over time. Findings highlight the importance of prioritizing HIV prevention and treatment for MSM and clients of FSW whose unmet needs now contribute most to onward transmission, while maintaining services that successfully reduced transmissions in the context of commercial sex. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
15254135
Volume :
86
Issue :
4
Database :
Academic Search Index
Journal :
JAIDS: Journal of Acquired Immune Deficiency Syndromes
Publication Type :
Academic Journal
Accession number :
149659421
Full Text :
https://doi.org/10.1097/qai.0000000000002580