Evaluating the Impact of Test-and-Treat on the HIV Epidemic among MSM in China Using a Mathematical Model.
Evaluating the Impact of Test-and-Treat on the HIV Epidemic among MSM in China Using a Mathematical Model.
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DOI：
10.1371/journal.pone.0126893
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Xu J
中科院分区：
文献类型：
--
作者：
Luo S;Han L;Lu H;Dou Z;Tao Q;Khoshnood K;Wu Z;Xu J
各种研究模拟了检测和治疗政策对全球艾滋病毒流行的影响。然而，很少有建模研究考虑到中国的背景。为了了解检测和治疗对中国男男性行为者（MSM）艾滋病流行的潜在影响，我们开发了一个数学模型来评估该策略的影响。基于HIV感染者和AIDS患者（PLWHA）CD 4细胞计数的自然史，构建了中国MSM人群HIV传播的动态房室模型，预测了10年内HIV新发感染者和流行率。我们预测了每年的艾滋病新发感染人数和男男性接触者艾滋病病毒感染者和艾滋病患者的总数（基于北京数据）在以下条件下，2010年至2022年：（1）目前的做法（2）2013年，检测率和抗逆转录病毒治疗覆盖率均提高到70%;（3）检测率和ART覆盖率在2013年均提高到90%;（4）检测率和ART覆盖率自2013年以来逐年递增，直至90%。基于我们的模型，如果在中国男男性行为者中实施艾滋病检测和治疗政策，10年（2013-2022年）的艾滋病新发感染者总数将比现行政策减少50.6%-70.9%。自2013年以来，当艾滋病毒感染者的抗逆转录病毒治疗覆盖率增加到58%时，到2015年，艾滋病毒新感染者的曲线将出现“转折点”。如果自2013年以来，检测率从50%提高到70%，艾滋病毒感染者的治疗覆盖率提高到55%，那么到2015年，艾滋病毒新感染者的年度人数可能会减少25%。实施检测和治疗策略可能会显着减少中国MSM中的HIV新发感染。需要加大力度提高中国男男性接触者的HIV检测率和ART覆盖率。
Various studies have modeled the impact of test-and-treat policies on the HIV epidemics worldwide. However, few modeling studies have taken into account China’s context. To understand the potential effect of test-and-treat on the HIV epidemic among men who have sex with men (MSM) in China, we developed a mathematical model to evaluate the impact of the strategy. Based on the natural history of the CD4 count of people living with HIV and AIDS (PLWHA), we constructed a dynamic compartmental model of HIV transmission among Chinese MSM to project the number of HIV new infections and prevalence over 10 years. We predicted the annual number of HIV new infections and the total number of MSM living with HIV and AIDS (based on Beijing data) between 2010 and 2022 under the following conditions: (1) current practice (testing rate of 50% and ART coverage of 39%); (2) both testing rate and ART coverage increasing to 70% in 2013; (3) both testing rate and ART coverage increasing to 90% in 2013; and (4) both testing rate and ART coverage increasing gradually every year until 90% since 2013. Based on our model, if the HIV test-and-treat policy was implemented among Chinese MSM, the total number of HIV new infections over 10 years (2013-2022) would be reduced by 50.6-70.9% compared with the current policy. When ART coverage for PLWHA increased to 58% since 2013, the ‘turning point’ would occur on the curve of HIV new infections by 2015. A 25% reduction in annual number of HIV new infections by 2015 might be achieved if the testing rate increased from 50% to 70% and treatment coverage for PLWHA increased to 55% since 2013. Implementation of the test-and-treat strategy may significantly reduce HIV new infections among MSM in China. Great efforts need to be made to scale up HIV testing rate and ART coverage among Chinese MSM.
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影响因子：
56.9
作者：
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通讯作者：
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DOI：
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发表时间：
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期刊：
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影响因子：
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