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Targeting HIV services to male migrant workers in southern Africa would not reverse generalized HIV epidemics in their home communities: a mathematical modeling analysis.
- Source :
- International Health (1876-3413); Mar2015, Vol. 7 Issue 2, p107-113, 7p
- Publication Year :
- 2015
-
Abstract
- Background Migrant populations such as mine workers contributed to the spread of HIV in sub-Saharan Africa. We used a mathematical model to estimate the community-wide impact of targeting treatment and prevention to male migrants. Methods We augmented an individual-based network model, EMOD-HIV v0.8, to include an age-dependent propensity for males to migrate. Migrants were exposed to HIV outside their home community, but continued to participate in HIV transmission in the community during periodic visits. Results Migrant-targeted interventions would have been transformative in the 1980s to 1990s, but post-2015 impacts were more modest. When targetable migrants comprised 2% of adult males, workplace HIV prevention averted 3.5% of community-wide infections over 20 years. Targeted treatment averted 8.5% of all-cause deaths among migrants. When migrants comprised 10% of males, workplace prevention averted 16.2% of infections in the community, one-quarter of which were among migrants. Workplace prevention and treatment acted synergistically, averting 17.1% of community infections and 11.6% of deaths among migrants. These estimates do not include prevention of secondary spread of HIV or tuberculosis at the workplace. Conclusions Though cost-effective, targeting migrants cannot collapse generalized epidemics in their home communities. Such a strategy would only have been possible prior to the early 1990s. However, migrant-targeted interventions synergize with general-population expansion of HIV services. [ABSTRACT FROM PUBLISHER]
- Subjects :
- EPIDEMIOLOGY
HIV
AIDS
EMIGRATION & immigration
INFORMATION modeling
Subjects
Details
- Language :
- English
- ISSN :
- 18763413
- Volume :
- 7
- Issue :
- 2
- Database :
- Complementary Index
- Journal :
- International Health (1876-3413)
- Publication Type :
- Academic Journal
- Accession number :
- 101451355
- Full Text :
- https://doi.org/10.1093/inthealth/ihv011