TY - JOUR
T1 - Measuring HIV acquisitions among partners of key populations: estimates from HIV transmission dynamic models
AU - Silhol, Romain
AU - Anderson, Rebecca L.
AU - Stevens, Oliver
AU - Stannah, James
AU - Booton, Ross D.
AU - Baral, Stefan
AU - Dimitrov, Dobromir
AU - Mitchell, Kate M.
AU - Donnell, Deborah
AU - Bershteyn, Anna
AU - Brown, Tim
AU - Kelly, Sherrie L.
AU - Kim, Hae-Young
AU - Johnson, Leigh F.
AU - Maheu-Giroux, Mathieu
AU - Martin-Hughes, Rowan
AU - Mishra, Sharmistha
AU - Peerapatanapokin, Wiwat
AU - Stone, Jack
AU - Stover, John
AU - Teng, Yu
AU - Vickerman, Peter
AU - Garcia, Sonia Arias
AU - Korenromp, Eline
AU - Imai-Eaton, Jeffrey W.
AU - Boily, Marie-Claude
PY - 2024/1/1
Y1 - 2024/1/1
N2 - BACKGROUND: Key populations (KPs), including female sex workers (FSWs), gay men and other men who have sex with men (MSM), people who inject drugs (PWID), and transgender women (TGW) experience disproportionate risks of HIV acquisition. The UNAIDS Global AIDS 2022 Update reported that one-quarter of all new HIV infections occurred among their non-KP sexual partners. However, this fraction relied on heuristics regarding the ratio of new infections that KPs transmitted to their non-KP partners to the new infections acquired among KPs (herein referred to as "infection ratios"). We recalculated these ratios using dynamic transmission models.SETTING: One hundred seventy-eight settings (106 countries).METHODS: Infection ratios for FSW, MSM, PWID, TGW, and clients of FSW were estimated from 12 models for 2020.RESULTS: Median model estimates of infection ratios were 0.7 (interquartile range: 0.5-1.0; n = 172 estimates) and 1.2 (0.8-1.8; n = 127) for acquisitions from FSW clients and transmissions from FSW to all their non-KP partners, respectively, which were comparable with the previous UNAIDS assumptions (0.2-1.5 across regions). Model estimates for female partners of MSM were 0.5 (0.2-0.8; n = 20) and 0.3 (0.2-0.4; n = 10) for partners of PWID across settings in Eastern and Southern Africa, lower than the corresponding UNAIDS assumptions (0.9 and 0.8, respectively). The few available model estimates for TGW were higher [5.1 (1.2-7.0; n = 8)] than the UNAIDS assumptions (0.1-0.3). Model estimates for non-FSW partners of FSW clients in Western and Central Africa were high (1.7; 1.0-2.3; n = 29).CONCLUSIONS: Ratios of new infections among non-KP partners relative to KP were high, confirming the importance of better addressing prevention and treatment needs among KP as central to reducing overall HIV incidence.
AB - BACKGROUND: Key populations (KPs), including female sex workers (FSWs), gay men and other men who have sex with men (MSM), people who inject drugs (PWID), and transgender women (TGW) experience disproportionate risks of HIV acquisition. The UNAIDS Global AIDS 2022 Update reported that one-quarter of all new HIV infections occurred among their non-KP sexual partners. However, this fraction relied on heuristics regarding the ratio of new infections that KPs transmitted to their non-KP partners to the new infections acquired among KPs (herein referred to as "infection ratios"). We recalculated these ratios using dynamic transmission models.SETTING: One hundred seventy-eight settings (106 countries).METHODS: Infection ratios for FSW, MSM, PWID, TGW, and clients of FSW were estimated from 12 models for 2020.RESULTS: Median model estimates of infection ratios were 0.7 (interquartile range: 0.5-1.0; n = 172 estimates) and 1.2 (0.8-1.8; n = 127) for acquisitions from FSW clients and transmissions from FSW to all their non-KP partners, respectively, which were comparable with the previous UNAIDS assumptions (0.2-1.5 across regions). Model estimates for female partners of MSM were 0.5 (0.2-0.8; n = 20) and 0.3 (0.2-0.4; n = 10) for partners of PWID across settings in Eastern and Southern Africa, lower than the corresponding UNAIDS assumptions (0.9 and 0.8, respectively). The few available model estimates for TGW were higher [5.1 (1.2-7.0; n = 8)] than the UNAIDS assumptions (0.1-0.3). Model estimates for non-FSW partners of FSW clients in Western and Central Africa were high (1.7; 1.0-2.3; n = 29).CONCLUSIONS: Ratios of new infections among non-KP partners relative to KP were high, confirming the importance of better addressing prevention and treatment needs among KP as central to reducing overall HIV incidence.
KW - Male
KW - Humans
KW - Female
KW - HIV Infections/epidemiology
KW - Homosexuality, Male
KW - Sex Workers
KW - Sexual and Gender Minorities
KW - Substance Abuse, Intravenous
KW - HIV incidence
KW - clients of female sex workers
KW - men who have sex with men
KW - key populations
KW - female sex workers
KW - people who inject drugs
KW - transgender women
U2 - 10.1097/QAI.0000000000003334
DO - 10.1097/QAI.0000000000003334
M3 - Article
C2 - 38180739
SN - 1525-4135
VL - 95
SP - e59-e69
JO - Journal of Acquired Immune Deficiency Syndromes
JF - Journal of Acquired Immune Deficiency Syndromes
IS - 1S
ER -
