The impact of HIV epidemic phases on the effectiveness of core group interventions: insights from mathematical models

Mathematical models have highlighted the disproportionate contribution of core group transmitters to the spread of sexually transmitted diseases. Because the effectiveness of interventions varies with time, it has been suggested that epidemic phases should be considered in the design of prevention s...

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Bibliographic Details
Published in:Sexually transmitted infections 2002-04, Vol.78 (suppl 1), p.i78-i90
Main Authors: Boily, M-C, Lowndes, C, Alary, M
Format: Article
Language:English
Subjects:
Acquired immune deficiency syndrome
AIDS
Benin - epidemiology
Computer Simulation
Condoms
Developing Countries
Disease transmission
epidemic
Epidemics
Female
Gonorrhea - prevention & control
Gonorrhea - transmission
HIV
HIV Infections - mortality
HIV Infections - prevention & control
HIV Infections - transmission
Human immunodeficiency virus
Humans
Male
Mass Screening
mathematical model
Models, Statistical
Prevalence
Public Health Practice
Sexual Behavior
Space-Time Clustering
Symposium
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Summary:Mathematical models have highlighted the disproportionate contribution of core group transmitters to the spread of sexually transmitted diseases. Because the effectiveness of interventions varies with time, it has been suggested that epidemic phases should be considered in the design of prevention strategies. This study aimed to examine the impact of HIV epidemic phases on the effectiveness of HIV interventions based on gonorrhoea screening and condom use, targeted to core groups. The results are based on a mathematical model of gonorrhoea and HIV transmission in a relatively slow spreading HIV epidemic using Cotonou (Benin) as an example. For epidemics with a low reproductive potential modest core group interventions can significantly reduce HIV incidence and prevalence. As the epidemic matures, effective interventions should also incorporate core and non-core populations. For epidemics with a high reproductive potential, core group interventions are necessary but not sufficient to have a rapid and large scale impact. A more general population approach is also needed early in the epidemic. Epidemic phases are also important in the evaluation of prevention strategies.
ISSN:1368-4973
1472-3263
DOI:10.1136/sti.78.suppl_1.i78