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Khanna AS, Edali M, Ozik J, Collier N, Hotton A, Skwara A, Ardestani BM, Brewer R, Fujimoto K, Harawa N, Schneider JA. Projecting the number of new HIV infections to formulate the "Getting to Zero" strategy in Illinois, USA. Math Biosci Eng 2021; 18:3922-3938. [PMID: 34198418 PMCID: PMC8281377 DOI: 10.3934/mbe.2021196] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
OBJECTIVES Getting to Zero (GTZ) initiatives focus on expanding use of antiretroviral treatment (ART) and pre-exposure prophylaxis (PrEP) to eliminate new HIV infections. Computational models help inform policies for implementation of ART and PrEP continuums. Such models, however, vary in their design, and may yield inconsistent predictions. Using multiple approaches can help assess the consistency in results obtained from varied modeling frameworks, and can inform optimal implementation strategies. METHODS A study using three different modeling approaches is conducted. Two approaches use statistical time series analysis techniques that incorporate temporal HIV incidence data. A third approach uses stochastic stimulation, conducted using an agent-based network model (ABNM). All three approaches are used to project HIV incidence among a key population, young Black MSM (YBMSM), over the course of the GTZ implementation period (2016-2030). RESULTS All three approaches suggest that simultaneously increasing PrEP and ART uptake is likely to be more effective than increasing only one, but increasing ART and PrEP by 20% points may not eliminate new HIV infections among YBMSM. The results further suggest that a 20% increase in ART is likely to be more effective than a 20% increase in PrEP. All three methods consistently project that increasing ART and PrEP by 30% simultaneously can help reach GTZ goals. CONCLUSIONS Increasing PrEP and ART uptake by about 30% might be necessary to accomplish GTZ goals. Such scale-up may require addressing psychosocial and structural barriers to engagement in HIV and PrEP care continuums. ABNMs and other flexible modeling approaches can be extended to examine specific interventions that address these barriers and may provide important data to guide the successful intervention implementation.
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Affiliation(s)
- Aditya Subhash Khanna
- Center for Alcohol and Addiction Studies, Brown University, Providence RI USA
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence RI USA
| | - Mert Edali
- Chicago Center for HIV Elimination, The University of Chicago, Chicago, IL, USA
- Department of Medicine, The University of Chicago, Chicago, IL, USA
- Department of Industrial Engineering, Yildiz Technical University, Besiktas, Istanbul 34349, Turkey
| | - Jonathan Ozik
- Decision and Infrastructure Sciences Division, Argonne National Laboratory, Lemont, IL, USA
| | - Nicholson Collier
- Decision and Infrastructure Sciences Division, Argonne National Laboratory, Lemont, IL, USA
| | - Anna Hotton
- Chicago Center for HIV Elimination, The University of Chicago, Chicago, IL, USA
- Department of Medicine, The University of Chicago, Chicago, IL, USA
| | - Abigail Skwara
- Chicago Center for HIV Elimination, The University of Chicago, Chicago, IL, USA
- Department of Medicine, The University of Chicago, Chicago, IL, USA
| | - Babak Mahdavi Ardestani
- Chicago Center for HIV Elimination, The University of Chicago, Chicago, IL, USA
- Department of Medicine, The University of Chicago, Chicago, IL, USA
| | - Russell Brewer
- Chicago Center for HIV Elimination, The University of Chicago, Chicago, IL, USA
- Department of Medicine, The University of Chicago, Chicago, IL, USA
| | - Kayo Fujimoto
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Nina Harawa
- Department of Psychiatry and Human Behavior, Charles R. Drew University, Los Angeles, CA, USA
- Department of Epidemiology, University of California, Los Angeles, CA, USA
| | - John A. Schneider
- Chicago Center for HIV Elimination, The University of Chicago, Chicago, IL, USA
- Department of Medicine, The University of Chicago, Chicago, IL, USA
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