Estimating the impact of combined prevention interventions targeting 15-24 years-old men and women in nyanza, Kenya
Background: Young males (YM) and especially young females (YF) (age 15-24) in sub-Saharan Africa are at a higher risk of HIV infection compared to older adults. HIV testing of young individuals facilitates early identification of their HIV+' status, prompt ART initiation, and provision of male circumcision and PrEP. We hypothesize that youth-prioritized combination interventions could have substantial impact on HIV incidence among them and the wider adult population. Methods: Using an age-sex-risk stratified mathematical model representing HIV heterosexual transmission in Nyanza, Kenya, we estimated the impact of leveraging HIV testing and counseling among Nyanza youth, prompt ART initiation (at CD4<=50 cells/mm3) based on knowledge of status, and further gender-specific intervention components: male circumcision for YM and reduction of partners and PrEP for YF. Results: We predict a reduction in HIV incidence over 10 years among youth by 34% (from 1.6% /person-years) and adults by 29% (from 1.3% /person-years), if the annual testing likelihood for youth increases to 90% (from 13%) with newly HIV-diagnosed youth increasing condom use by 30% and initiating ART promptly. The adult incidence is reduced 41% and 37% by further male and female specific interventions. The full combination package would decrease incidence by 60% and 48% among youth and adults; respectively. Conclusions: In populations where young people are at the highest risk of HIV infection, carefully prioritized, gender-specific intervention can have a substantial impact on the risk of infection, both in that group and the population overall.
Other professions or practice related to public health
Define combination interventions against HIV
Identify gender-specific prevention interventions against HIV
Compare HIV incidence with and without the interventions
Presenting author's disclosure statement:
Qualified on the content I am responsible for because: I am an associate research scientist in global health and the project manager on the MP3 Youth pilot study. I have worked closely with the mathematical modeler to identify the intervention components, assumptions, and impact of the MP3 Youth mathematical model. I have previously worked as an epidemiological researcher in the Virgin Islands and a Technical Adviser for sexual health research in Morocco and Cairo.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines,
and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed
in my presentation.