Estimating the epidemic consequences of HIV prevention gaps among key populations.
Estimating the epidemic consequences of HIV prevention gaps among key populations.
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DOI：
10.1002/jia2.25739
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发表时间：
2021-07
影响因子：
6
通讯作者：
Baral S
中科院分区：
文献类型：
--
作者：
Mishra S;Silhol R;Knight J;Phaswana-Mafuya R;Diouf D;Wang L;Schwartz S;Boily MC;Baral S
艾滋病毒流行病评估是用来说明艾滋病毒流行病和防治工作中的异质性和不公平现象。然而，评估中使用的传统措施已被证明低估了不成比例的继续传播风险，特别是在关键人群中。对此，越来越多的模拟研究将关键人群中预防和治疗需求未得到满足的后果（预防差距）量化为一段时间内传播人群归因分数（tPAFt）。为了帮助其解释和使用的方案实施者和政策制定者，我们概述和讨论了一个概念框架，通过传输建模作为衡量艾滋病毒预防差距的传播风险的tPAFt的理解和估计，并讨论了tPAFt的属性。传播风险的分布可以根据谁有不成比例的传播风险以及在何种条件下确定。后者反映了预防差距，包括通过治疗进行二级预防：其流行病后果可通过tPAFt量化。估计tPAFt的步骤包括参数化关注亚组经历的获得和前向传播风险，定义最相关的反事实情景，并阐明分析的时间范围和人群，以估计累积传播的相对差异;这些步骤可以反映关于前向传播风险的项目相关问题。tPAFt的关键特性包括：在较长时间范围内，向前传播的风险较大;看似相互排斥的tPAFt指标总和超过100%;有机会用人均tPAFt量化不成比例的向前传播风险的大小;估计值取决于迄今为止在减少预防差距和保持这些条件作为现状向前发展方面取得的成就。下一代艾滋病毒流行病评估有可能支持更具体的艾滋病毒应对措施，方法是确定不成比例的继续传播风险的异质性，并以人口各亚群过去、当前和未来的预防差距为条件。
HIV epidemic appraisals are used to characterize heterogeneity and inequities in the context of the HIV pandemic and the response. However, classic measures used in appraisals have been shown to underestimate disproportionate risks of onward transmission, particularly among key populations. In response, a growing number of modelling studies have quantified the consequences of unmet prevention and treatment needs (prevention gaps) among key populations as a transmission population attributable fraction over time (tPAFt). To aid its interpretation and use by programme implementers and policy makers, we outline and discuss a conceptual framework for understanding and estimating the tPAFt via transmission modelling as a measure of onward transmission risk from HIV prevention gaps; and discuss properties of the tPAFt. The distribution of onward transmission risks may be defined by who is at disproportionate risk of onward transmission, and under which conditions. The latter reflects prevention gaps, including secondary prevention via treatment: the epidemic consequences of which may be quantified by the tPAFt. Steps to estimating the tPAFt include parameterizing the acquisition and onward transmission risks experienced by the subgroup of interest, defining the most relevant counterfactual scenario, and articulating the time‐horizon of analyses and population among whom to estimate the relative difference in cumulative transmissions; such steps could reflect programme‐relevant questions about onward transmission risks. Key properties of the tPAFt include larger onward transmission risks over longer time‐horizons; seemingly mutually exclusive tPAFt measures summing to greater than 100%; an opportunity to quantify the magnitude of disproportionate onward transmission risks with a per‐capita tPAFt; and that estimates are conditional on what has been achieved so far in reducing prevention gaps and maintaining those conditions moving forward as the status quo. The next generation of HIV epidemic appraisals has the potential to support a more specific HIV response by characterizing heterogeneity in disproportionate risks of onward transmission which are defined and conditioned on the past, current and future prevention gaps across subsets of the population.
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影响因子：
6
作者：
Mukandavire C;Walker J;Schwartz S;Boily MC;Danon L;Lyons C;Diouf D;Liestman B;Diouf NL;Drame F;Coly K;Muhire RSM;Thiam S;Diallo PAN;Kane CT;Ndour C;Volz E;Mishra S;Baral S;Vickerman P
通讯作者：
Vickerman P
影响因子：
56.3
作者：
Looker, Katharine J.;Welton, Nicky J.;Gottlieb, Sami L.
通讯作者：
Gottlieb, Sami L.
DOI：
10.1097/qai.0000000000001434
发表时间：
2017-08-15
影响因子：
3.6
作者：
Maheu-Giroux, Mathieu;Vesga, Juan F.;Boily, Marie-Claude
通讯作者：
Boily, Marie-Claude
影响因子：
3.6
作者：
Stahlman S;Johnston LG;Yah C;Ketende S;Maziya S;Trapence G;Jumbe V;Sithole B;Mothopeng T;Mnisi Z;Baral S
通讯作者：
Baral S
影响因子：
168.9
作者：
Beyrer, Chris;Baral, Stefan D.;van Griensven, Frits;Goodreau, Steven M.;Chariyalertsak, Suwat;Wirtz, Andrea L.;Brookmeyer, Ron
通讯作者：
Brookmeyer, Ron