Impact of increased diagnosis for early HIV infection and immediate antiretroviral treatment initiation on HIV transmission among men who have sex with men in the Netherlands Article Swipe
Alexandra Teslya
,
Janneke C. M. Heijne
,
Maarten F. Schim van der Loeff
,
Ard van Sighem
,
Jacob Aiden Roberts
,
Maartje Dijkstra
,
Godelieve J. de Bree
,
Axel J. Schmidt
,
Kai J. Jonas
,
Mirjam Kretzschmar
,
Ganna Rozhnova
·
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.1101/2024.04.10.24305619
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.1101/2024.04.10.24305619
The number of new HIV infections among men who have sex with men (MSM) in the Netherlands has been decreasing, but additional efforts are required to bring it further down. This study aims to assess the impact of increased diagnosis for early HIV infection combined with immediate antiretroviral treatment (ART) initiation on reducing HIV transmission among MSM. We developed an agent-based model calibrated to HIV surveillance and sexual behavior data for MSM in the Netherlands. We simulated a 10-year intervention that accelerates HIV diagnosis during the first 3 or 6 months after HIV acquisition across five levels of increased diagnosis rates (2, 4, 8, 16, and 32-fold), followed by immediate ART initiation. The upper limit of the intervention’s impact over 10 years is projected to lower median cumulative HIV infections from 469 (interquartile range [IQR]: 300–681), projected without the intervention, to 184 (IQR: 142-–239), denoted as maximum impact. A 16-fold increase in the diagnosis rate within 3 months after HIV acquisition results in 263 (IQR: 182–349) infections. Further increases in the diagnosis rate show diminishing returns, failing to reach the maximum impact. By extending the scope of the intervention to individuals who acquired HIV infection within the previous 6 months, a 16-fold increase in the diagnosis rate approaches closely the maximum impact of the intervention. Accelerating early HIV diagnosis through increased awareness, screening, and testing can further reduce transmission among MSM, provided diagnosis rates rise significantly. Meeting this goal necessitates a stakeholder needs assessment. Author summary In recent years, in the Netherlands, the annual number of new HIV infections in the population of men who have sex with men (MSM) has been declining. Using an agent-based model calibrated to the current state of the HIV epidemic in MSM in the Netherlands, we explored the potential impact of an intervention that accelerates diagnosis in individuals with early HIV infection and facilitates immediate antiretroviral treatment initiation on further reducing the number of new HIV infections. Our projections indicate that such an intervention can noticeably reduce onward HIV transmission in the population of MSM. To achieve this, the diagnosis rate for individuals with early HIV infection would need to increase 16-fold. Increasing the diagnosis rate beyond this level is expected to bring marginal improvements, without approaching the maximum potential of the intervention. Extending the intervention to target individuals who acquired HIV within the previous 6 months could further lower the number of new HIV infections, bringing it closer to the maximum impact. Therefore, the intervention, which achieves an increased diagnosis rate in individuals with early HIV who then immediately initiate ART, can bring forth substantial reductions in new HIV infections, even against a backdrop of an already declining trend of the HIV epidemic.
Related Topics
Concepts
Human immunodeficiency virus (HIV)
Antiretroviral treatment
Transmission (telecommunications)
Medicine
Antiretroviral therapy
HIV diagnosis
Immunology
Viral load
Electrical engineering
Engineering
Metadata
- Type
- preprint
- Language
- en
- Landing Page
- https://doi.org/10.1101/2024.04.10.24305619
- https://www.medrxiv.org/content/medrxiv/early/2024/04/12/2024.04.10.24305619.full.pdf
- OA Status
- green
- References
- 27
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4394785500
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4394785500Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1101/2024.04.10.24305619Digital Object Identifier
- Title
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Impact of increased diagnosis for early HIV infection and immediate antiretroviral treatment initiation on HIV transmission among men who have sex with men in the NetherlandsWork title
- Type
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preprintOpenAlex work type
- Language
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enPrimary language
- Publication year
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2024Year of publication
- Publication date
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2024-04-12Full publication date if available
- Authors
-
Alexandra Teslya, Janneke C. M. Heijne, Maarten F. Schim van der Loeff, Ard van Sighem, Jacob Aiden Roberts, Maartje Dijkstra, Godelieve J. de Bree, Axel J. Schmidt, Kai J. Jonas, Mirjam Kretzschmar, Ganna RozhnovaList of authors in order
- Landing page
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https://doi.org/10.1101/2024.04.10.24305619Publisher landing page
- PDF URL
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https://www.medrxiv.org/content/medrxiv/early/2024/04/12/2024.04.10.24305619.full.pdfDirect link to full text PDF
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YesWhether a free full text is available
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greenOpen access status per OpenAlex
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https://www.medrxiv.org/content/medrxiv/early/2024/04/12/2024.04.10.24305619.full.pdfDirect OA link when available
- Concepts
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Human immunodeficiency virus (HIV), Antiretroviral treatment, Transmission (telecommunications), Medicine, Antiretroviral therapy, HIV diagnosis, Immunology, Viral load, Electrical engineering, EngineeringTop concepts (fields/topics) attached by OpenAlex
- Cited by
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0Total citation count in OpenAlex
- References (count)
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27Number of works referenced by this work
- Related works (count)
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10Other works algorithmically related by OpenAlex
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