1 / 7

Background Antiretroviral therapy (ART) prevents HIV transmission

Modelling potential impact of expanding access to anti-retroviral therapy on the concentrated HIV epidemic in Viet Nam Masaya Kato, Reuben Granich , Hoang Tran Vu, Patrick Nadol, Keith Sabin, Amitabh Suthar and Brian Williams. Background Antiretroviral therapy (ART) prevents HIV transmission

tamas
Download Presentation

Background Antiretroviral therapy (ART) prevents HIV transmission

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Modelling potential impact of expanding access to anti-retroviral therapy on the concentrated HIV epidemic in Viet NamMasaya Kato, Reuben Granich, Hoang Tran Vu, Patrick Nadol, Keith Sabin, Amitabh Suthar and Brian Williams Background Antiretroviral therapy (ART) prevents HIV transmission Concentrated epidemic with highest HIV prevalence in people who inject drugs (PWID) 250,000 people with HIV; 61,000 people on ART; Prevalence 0.45%; Injection drug users 13.4% Objective To identify optimal strategies and targets for HIV control that include early ART in Viet Nam’s epidemic Data sources Available data from Can Tho province, Viet Nam Intervention scenarios Regular HIV testing + immediate ART (irrespective of CD4) Scale-up 2010-2015; maintenance by 2050 Other HIV prevention interventions * Sources: General Statistic Office (population), VAAC/MOH

  2. Model is based on 7 sub-populations MSM injecting MSM Non-injecting IDU LRW MCF FSW injecting FSW Non-injecting Red arrow: Transmission via needle sharing Blue arrow: Sexual transmission Pink circle: Transmission within group IDU: Injection drug users MSM: Men having sex with men FSW: Female sex workers MCF: Male clients of FSW LRW: Low risk women

  3. Routine testing + early ART significantly reduces new infectionTesting once 1-2 years most cost-effective Cumulative cost 2010-2050 Cumulative new infections 2010-50 Cost / New infection averted 2010-2050 Annual cost 2010-2050

  4. Prioritizing specific groups Cumulative new infections 2010-50 Cumulative cost 2010-50 Cost per infection averted 2010-50 Prioritizing injection drug users, followed by female sex workers, is the most effective and cost-effective

  5. Combination prevention scenarios Scenario 1: Baseline Condom, methadone maintenance, ART imitated at CD4 350: Maintain current level Scenario 2: Current government targets Condom, methadone maintenance scale-up (50 and 80%) ART imitated at CD4 350: scale-up to 80% in 2020 Scenario 3: Current government targets + TasP Scenario 2 plus Routine testing + immediate ART (regardless of CD4) for key populations (IDU, FSW, MSM) 70000 40000 35000 60000 30000 50000 25000 40000 20000 30000 15000 20000 10000 10000 5000 0 0 Baseline Current government targets Current government targets + TasP ART needs 2010-2050 New HIV infection 2010-2050 New HIV infection ART patient-years Routine testing and TasP impact of early ART prioritizing key populationscombined with other prevention scale-up quite effective in reducing new infection while it does not require extra ART patient years

  6. Limitations / Conclusion • Limitations • Modelled data from a single province • Validity of assumptions • Frequent HIV testing and earlier ART could have a substantial impact on Viet Nam’s concentrated epidemic • Combined approaches potentiate the impact • OST, NSP and condom also likely to have high a impact on new infections • Prioritizing key-affected populations, especially people who inject drugs, likely enhance effectiveness/cost-effectiveness

  7. Thank you

More Related