The differential impacts of non-locally acquired infections and treatment interventions on heterosexual HIV transmission in Hong Kong.
INTRODUCTION:Heterosexual infections have contributed to a high proportion of the HIV burden in Asia and Eastern Europe. Human mobility and non-local infections are important features in some cities/countries. An understanding of the determinants of the sustained growth of the heterosexual HIV epide...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2020-01-01
|
| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0237433 |
| _version_ | 1819125481800204288 |
|---|---|
| author | Ngai Sze Wong Man Po Lee Ka Hing Wong Owen T Y Tsang Shui Shan Lee |
| author_facet | Ngai Sze Wong Man Po Lee Ka Hing Wong Owen T Y Tsang Shui Shan Lee |
| author_sort | Ngai Sze Wong |
| collection | DOAJ |
| description | INTRODUCTION:Heterosexual infections have contributed to a high proportion of the HIV burden in Asia and Eastern Europe. Human mobility and non-local infections are important features in some cities/countries. An understanding of the determinants of the sustained growth of the heterosexual HIV epidemics would enable the potential impacts of treatment-based interventions to be assessed. METHODS:We developed a compartmental model for heterosexual HIV transmissions, parameterized by clinical and surveillance data (1984-2014) in Hong Kong. HIV sequence data were included for examining genetic linkages and clustering pattern. We performed sensitivity analyses to evaluate effects of high-risk sexual partnership and proportions of non-locally acquired infections. Four hypothetical interventions (a) immediate treatment, (b) enhancement of retention in care, (c) HIV testing campaigns, and (d) test-and-treat strategy, were examined. RESULTS:Data of 2174 patients (723 female and 1451 male) diagnosed with HIV between 1984 and 2012 in Hong Kong were collected for model parameterization. Among 1229 sequences of non-MSM (men who have sex with men) patients, 70% were isolates and 17% were either dyads or triads. In base-case scenario, the total estimated number of new infections in 2012-2023 would be 672 for male and 452 for female. Following 100% retention in care intervention, the total proportion of averted new infections in 2012-2023 would be 7% for male and 10% for female. HIV testing campaign in 2012 and 2017 followed by 100% immediate treatment strategy would avert 5% and 9% of male and female new infections, respectively. In the epidemic model, an increase of high-risk sexual partnership from 6% to 9% would increase the epidemic growth (annual number of newly diagnosed and newly infected cases) by about 10%. If no non-locally acquired infection occurred as from 2012, the epidemic growth would slump. To control the heterosexual epidemic, periodic HIV testing at 5-year intervals with immediate treatment would avert 5-13% of annual new infections in 2013-2023. CONCLUSIONS:Enhanced HIV testing with immediate treatment is most effective in controlling the heterosexual epidemic, the impacts of which might however be attenuated by any increase of non-locally acquired infection, assuming little variations of high risk partnership over time. |
| first_indexed | 2024-12-22T07:40:50Z |
| format | Article |
| id | doaj.art-ca2d8910661447858169d7a1cdbe2125 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-22T07:40:50Z |
| publishDate | 2020-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-ca2d8910661447858169d7a1cdbe21252022-12-21T18:33:44ZengPublic Library of Science (PLoS)PLoS ONE1932-62032020-01-01158e023743310.1371/journal.pone.0237433The differential impacts of non-locally acquired infections and treatment interventions on heterosexual HIV transmission in Hong Kong.Ngai Sze WongMan Po LeeKa Hing WongOwen T Y TsangShui Shan LeeINTRODUCTION:Heterosexual infections have contributed to a high proportion of the HIV burden in Asia and Eastern Europe. Human mobility and non-local infections are important features in some cities/countries. An understanding of the determinants of the sustained growth of the heterosexual HIV epidemics would enable the potential impacts of treatment-based interventions to be assessed. METHODS:We developed a compartmental model for heterosexual HIV transmissions, parameterized by clinical and surveillance data (1984-2014) in Hong Kong. HIV sequence data were included for examining genetic linkages and clustering pattern. We performed sensitivity analyses to evaluate effects of high-risk sexual partnership and proportions of non-locally acquired infections. Four hypothetical interventions (a) immediate treatment, (b) enhancement of retention in care, (c) HIV testing campaigns, and (d) test-and-treat strategy, were examined. RESULTS:Data of 2174 patients (723 female and 1451 male) diagnosed with HIV between 1984 and 2012 in Hong Kong were collected for model parameterization. Among 1229 sequences of non-MSM (men who have sex with men) patients, 70% were isolates and 17% were either dyads or triads. In base-case scenario, the total estimated number of new infections in 2012-2023 would be 672 for male and 452 for female. Following 100% retention in care intervention, the total proportion of averted new infections in 2012-2023 would be 7% for male and 10% for female. HIV testing campaign in 2012 and 2017 followed by 100% immediate treatment strategy would avert 5% and 9% of male and female new infections, respectively. In the epidemic model, an increase of high-risk sexual partnership from 6% to 9% would increase the epidemic growth (annual number of newly diagnosed and newly infected cases) by about 10%. If no non-locally acquired infection occurred as from 2012, the epidemic growth would slump. To control the heterosexual epidemic, periodic HIV testing at 5-year intervals with immediate treatment would avert 5-13% of annual new infections in 2013-2023. CONCLUSIONS:Enhanced HIV testing with immediate treatment is most effective in controlling the heterosexual epidemic, the impacts of which might however be attenuated by any increase of non-locally acquired infection, assuming little variations of high risk partnership over time.https://doi.org/10.1371/journal.pone.0237433 |
| spellingShingle | Ngai Sze Wong Man Po Lee Ka Hing Wong Owen T Y Tsang Shui Shan Lee The differential impacts of non-locally acquired infections and treatment interventions on heterosexual HIV transmission in Hong Kong. PLoS ONE |
| title | The differential impacts of non-locally acquired infections and treatment interventions on heterosexual HIV transmission in Hong Kong. |
| title_full | The differential impacts of non-locally acquired infections and treatment interventions on heterosexual HIV transmission in Hong Kong. |
| title_fullStr | The differential impacts of non-locally acquired infections and treatment interventions on heterosexual HIV transmission in Hong Kong. |
| title_full_unstemmed | The differential impacts of non-locally acquired infections and treatment interventions on heterosexual HIV transmission in Hong Kong. |
| title_short | The differential impacts of non-locally acquired infections and treatment interventions on heterosexual HIV transmission in Hong Kong. |
| title_sort | differential impacts of non locally acquired infections and treatment interventions on heterosexual hiv transmission in hong kong |
| url | https://doi.org/10.1371/journal.pone.0237433 |
| work_keys_str_mv | AT ngaiszewong thedifferentialimpactsofnonlocallyacquiredinfectionsandtreatmentinterventionsonheterosexualhivtransmissioninhongkong AT manpolee thedifferentialimpactsofnonlocallyacquiredinfectionsandtreatmentinterventionsonheterosexualhivtransmissioninhongkong AT kahingwong thedifferentialimpactsofnonlocallyacquiredinfectionsandtreatmentinterventionsonheterosexualhivtransmissioninhongkong AT owentytsang thedifferentialimpactsofnonlocallyacquiredinfectionsandtreatmentinterventionsonheterosexualhivtransmissioninhongkong AT shuishanlee thedifferentialimpactsofnonlocallyacquiredinfectionsandtreatmentinterventionsonheterosexualhivtransmissioninhongkong AT ngaiszewong differentialimpactsofnonlocallyacquiredinfectionsandtreatmentinterventionsonheterosexualhivtransmissioninhongkong AT manpolee differentialimpactsofnonlocallyacquiredinfectionsandtreatmentinterventionsonheterosexualhivtransmissioninhongkong AT kahingwong differentialimpactsofnonlocallyacquiredinfectionsandtreatmentinterventionsonheterosexualhivtransmissioninhongkong AT owentytsang differentialimpactsofnonlocallyacquiredinfectionsandtreatmentinterventionsonheterosexualhivtransmissioninhongkong AT shuishanlee differentialimpactsofnonlocallyacquiredinfectionsandtreatmentinterventionsonheterosexualhivtransmissioninhongkong |