Modeling the HIV epidemic in MSM in Cyprus: reaching only the 95-95-95 cascade of care targets fails to reduce HIV incidence by 90% in 2030.

IF 1.2 4区 医学 Q4 HEALTH POLICY & SERVICES
Ilias Gountas, Katerina Pantavou, Georgios Siakallis, Anna Demetriou, Ioannis Demetriades, Georgios K Nikolopoulos
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Abstract

National responses should be improved and accelerated to meet the target of ending the Acquired ImmunoDeficiency Syndrome (AIDS) epidemic by 2030. In the Republic of Cyprus, Men who have Sex with Men (MSM) are disproportionately affected by Human Immunodeficiency Virus (HIV), accounting approximately for half of all annual HIV diagnoses. This study assesses the evolution of HIV incidence in MSM in Cyprus until 2030 using a model calibrated to Cypriot epidemiological data. Four scenarios were examined: status quo, two scenarios focusing on introducing Pre-Exposure Prophylaxis (PrEP), and a 90% HIV incidence reduction scenario. Reaching only the 95-95-95 HIV cascade of care targets among MSM would reduce HIV incidence by 48.6% by 2030 compared to 2015. Initiating a PrEP intervention only for high risk MSM would cause a modest further reduction in HIV incidence. To meet the 90% reduction target, PrEP should be expanded to both high and medium risk MSM and, after 2025, behavioral interventions should be implemented so as high-risk MSM gradually move to the medium-risk category. Cyprus will not reach the HIV incidence reduction target by 2030 unless PrEP is gradually promoted and delivered to all high and medium risk MSM along with awareness and behavioral interventions.

塞浦路斯男男性行为者艾滋病毒流行病模型:仅达到 95-95-95 级护理目标无法在 2030 年将艾滋病毒发病率降低 90%。
应改进并加快国家应对措施,以实现到 2030 年结束获得性免疫缺陷综合症(艾滋病)流行的目标。在塞浦路斯共和国,男男性行为者(MSM)受人类免疫缺陷病毒(HIV)的影响尤为严重,约占每年所有 HIV 诊断病例的一半。本研究使用根据塞浦路斯流行病学数据校准的模型,评估了 2030 年前塞浦路斯男男性行为者艾滋病发病率的变化情况。研究考察了四种情景:维持现状、两种侧重于引入暴露前预防(PrEP)的情景,以及艾滋病毒发病率降低 90% 的情景。与 2015 年相比,仅在男男性行为者中实现 95-95-95 HIV 级联护理目标就能在 2030 年将 HIV 感染率降低 48.6%。仅针对高风险男男性行为者启动 PrEP 干预措施将使艾滋病发病率进一步小幅下降。为实现减少 90% 的目标,应将 PrEP 扩大到高风险和中风险 MSM,并在 2025 年后实施行为干预,使高风险 MSM 逐步转入中风险类别。除非逐步推广 PrEP,并向所有高危和中危 MSM 提供,同时进行宣传和行为干预,否则塞浦路斯到 2030 年将无法实现降低艾滋病毒发病率的目标。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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CiteScore
3.50
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0.00%
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172
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