%0 Journal Article
%T Modeling the Impact on HIV Incidence of Combination Prevention Strategies among Men Who Have Sex with Men in Beijing, China
%A Jie Lou
%A Meridith Blevins
%A Yuhua Ruan
%A Sten H. Vermund
%A Sanyi Tang
%A Glenn F. Webb
%A Bryan E. Shepherd
%A Xiong He
%A Hongyan Lu
%A Yiming Shao
%A Han-Zhu Qian
%J PLOS ONE
%D 2014
%I Public Library of Science (PLoS)
%R 10.1371/journal.pone.0090985
%X Objective To project the HIV/AIDS epidemics among men who have sex with men (MSM) under different combinations of HIV testing and linkage to care (TLC) interventions including antiretroviral therapy (ART) in Beijing, China. Design Mathematical modeling. Methods Using a mathematical model to fit prevalence estimates from 2000每2010, we projected trends in HIV prevalence and incidence during 2011每2020 under five scenarios: (S1) current intervention levels by averaging 2000每2010 coverage; (S2) increased ART coverage with current TLC; (S3) increased TLC/ART coverage; (S4) increased condom use; and (S5) increased TLC/ART plus increased condom use. Results The basic reproduction number based upon the current level of interventions is significantly higher than 1 ( confidence interval (CI), 1.83每2.35), suggesting that the HIV epidemic will continue to increase to 2020. Compared to the 2010 prevalence of 7.8%, the projected HIV prevalence in 2020 for the five prevention scenarios will be: (S1) Current coverage: 21.4% (95% CI, 9.9每31.7%); (S2) Increased ART: 19.9% (95% CI, 9.9每28.4%); (S3) Increased TLC/ART: 14.5% (95% CI, 7.0每23.8%); (S4) Increased condom use: 13.0% (95% CI, 9.8每28.4%); and (S5) Increased TLC/ART and condom use: 8.7% (95% CI, 5.4每11.5%). HIV epidemic will continue to rise () for S1每S4 even with hyperbolic coverage in the sensitivity analysis, and is expected to decline () for S5. Conclusion Our transmission model suggests that Beijing MSM will have a rapidly rising HIV epidemic. Even enhanced levels of TLC/ART will not interrupt epidemic expansion, despite optimistic assumptions for coverage. Promoting condom use is a crucial component of combination interventions.
%U http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0090985