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Objective: This study utilized a mathematical model to compare the dynamics of the Human Immunodeficiency Virus (HIV) epidemic in men who have sex with men (MSM) in China by different antiviral therapy strategies, and explored the impact of anti-retroviral therapy (ART), voluntary counseling and testing (VCT) and condom use on the transmission of HIV among MSM individually.
Design: The study is a research of theoretical epidemiology
Methods: A mathematical model was built to simulate the HIV and Acquired Immunodeficiency Syndrome (AIDS) epidemic among MSM in China starting in 2015. The different antiviral therapy strategies and the individual effects of these HIV/AIDS interventions among MSM were analyzed. A one-way sensitivity analysis was conducted to determine how the model results were impacted by each parameter individually.
Results: Compared to antiviral therapy strategies, cumulative HIV infections and AIDS cases will be reduced by 87.3% and 80.7%, respectively, in a universal test-and-treat strategy. Compared to current antiviral therapy strategies, cumulative HIV infections and cumulative AIDS cases will be reduced by 34%and 26.7%, respectively, in a universal test-and-treat strategy.
Based on an estimated minimum coverage, if ART against HIV infection is increased every one double, by 2025 cumulative HIV infections and AIDS cases have an average reduction of 24.2% and 23.2%, respectively. If the coverage of VCT is increased every one double, cumulative HIV infections and AIDS cases have an average reduction of 14.2% and 13.5%, respectively. If the instances of condom use are increased every one double, cumulative HIV infections and AIDS cases will have an average reduction of 69.5% and 66.3%, respectively.
Conclusions: Compared to current antiviral therapy strategies, a universal test-and-treat strategy can significantly reduce cumulative HIV infections and cumulative AIDS cases. Improving the coverage of current antiviral therapies, the coverage of VCT and the increase of condom use can effectively control the epidemic of AIDS among MSM in China. Among the three intervention strategies, increasing condom use coverage was found to be the most effective.
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