Epidemic dynamics, risk factors, 90-90-90 UNAIDS targets : Cote d’Ivoire

Project Type: non-protocol | Intervention and risk factors: Treatment as prevention (TasP) | Risk populations: Men who have sex with men (MSM), Women at risk, Young women and adolescents, Female sex workers (FSW) | Setting: Africa | Type of study: Public health | HPTN Relevance: Women at Risk SC, Substance Users SC, MSM SC, Integrated Strategies SC, Biomedical Sciences SC

Study objectives

This project aimed to do an in-country assessment of the HIV prevention gaps, including the HIV treatment gaps to reach the 90-90-90 UNAIDS targets, in various segments of the population, to estimate the cost of improving the HIV response, and to use mathematical models to assess the impact of closing these prevention gaps on the HIV epidemic in Cote d’Ivoire.

Modelling objectives

We aimed to develop and calibrate an age-stratified dynamical model of sexual and vertical HIV transmission among the general population, female sex workers (FSW), and men who have sex with men to detailed prevalence and intervention data from Cote d’Ivoire, one of the countries with the highest HIV incidence in West Africa with unmet HIV prevention and treatment needs and where key populations are important to the broader HIV epidemic, in order to:

  1. estimate the fraction of HIV infections averted by past interventions (condom use and HIV treatment), and the fraction of incident infections acquired and transmitted by different segment of the population and risk behaviour
  2. estimate the impact of various enhanced HIV treatment-as-prevention scenarios, including scaling up interventions to reach the UNAIDS targets, as well as the impact of 8 other scenarios, on HIV transmission in adults and children

  3.  estimate the fraction of HIV infections that could be averted if FSWs substituted anal intercourse for vaginal intercourse using a respondent-driven sampling survey of female sex workers and our calibrated HIV dynamic transmission model

Collaborators

Michel Alary
Centre de recherche du CHU de Québec-Université Laval, Quebec, Canada
Laval University

Mathieu Maheu Giroux
McGill University

Stef Baral
John Hopkins University, USA

Daouda Diouf
Enda Santé, Dakar, Sénégal.

Souleymane Diabate
Centre de recherche du CHU de Québec-Université Laval, Quebec, Canada

Additional Funding

UNAIDS Regional Office for West and Central Africa and the HPTN Modelling Centre, which is funded by the U.S. National Institutes of Health (NIH UM1 AI068617) through HPTN partially funded this work.

MMG’s work was supported by a Bisby Fellowship Prize and a HIV/AIDS Health Services/Population Health Fellowship from the Canadian Institutes of Health Research

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