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Modeling the Impact of New HIV Prevention Technologies in Sub-Saharan Africa

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Operations Research and Health Care Policy

Part of the book series: International Series in Operations Research & Management Science ((ISOR,volume 190))

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Abstract

Research has shown that several new technologies can be effective in reducing the transmission of HIV infection. Male circumcision was shown to reduce susceptibility to new infection by about 60% in trials in 2005 and 2007. In 2009, a large scale trial of an HIV vaccine showed some protective benefits. Research results released in 2010 showed effectiveness of oral pre-exposure prophylaxis and topical pre-exposure prophylaxis at levels around 40%. When new technologies become available national policy makers are faced with questions about whether to implement them, how much they will cost and how they should be implemented. Funders face similar questions. We have developed computer models to aid in policy development and planning. These models are intended to investigate questions such as “What will the impact be in terms of infections averted?”, “How much would a new program cost?”, and “Would the new program be cost-effective?” This chapter discusses models for male circumcision, pre-exposure prophylaxis, and HIV vaccines and their applications to inform policy makers.

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References

  1. Garnett G, Wilson DP (2011) Epidemic modeling. Curr Opin HIV AIDS 6:1–140

    Article  Google Scholar 

  2. Weiss H, Quigley MA, Hayes RJ (2000) Male circumcision and risk of HIV infection in sub-Saharan Africa: a systematic review and meta-analysis. AIDS 14:2361–2370

    Article  Google Scholar 

  3. Buvé A, Carael M, Hayes RB, Auvert B et al. (2001) Multicentre study on factors determining differences in rate of spread of HIV in sub-Saharan Africa: methods and prevalence of HIV infection. AIDS 15(Suppl 4):S5–S14

    Article  Google Scholar 

  4. Auvert B, Buvé A, Lagarde E et al. (2001) Male circumcision and HIV infection in four cities in sub-Saharan Africa. AIDS 15(Suppl 4):S31–S40

    Article  Google Scholar 

  5. Auvert B, Taljaard D, Lagarde E et al. (2005) Randomized, controlled intervention trial of male circumcision for reduction of HIV infection risk: the ANRS 1265 trial. PLoS Med 2:e298. doi:10.1371/journal.pmed.0020298

    Article  Google Scholar 

  6. Bailey RC, Moses S, Parker CB et al. (2007) Male circumcision HIV prevention young men in Kisumu, Kenya: a randomized controlled trial. Lancet 369:643–656

    Article  Google Scholar 

  7. Gray RH, Kigozi G, Serwdda D et al. (2007) Male circumcision for HIV prevention in men in Rakai, Uganda: a randomized trial. Lancet 359:657–666

    Article  Google Scholar 

  8. Williams BG, Lloyd-Smith JO, Gouws E, Hankins C, Getz WM et al. (2006) The potential impact of male circumcision on HIV in Sub-Saharan Africa. PLoS Med 3:e262. doi:10.1371/journal.pmed.0030262

    Article  Google Scholar 

  9. Nagelkerke NJ, Moses S, de Vlas SJ, Bailey RC (2007) Modelling the public health impact of male circumcision for HIV prevention in high prevalence areas in Africa. BMC Infect Dis 7:16

    Article  Google Scholar 

  10. Gray RH, Li X, Kigozi G, Serwadda D, Nalugoda F et al. (2007) The impact of male circumcision on HIV incidence and cost per infection prevented: a stochastic simulation model from Rakai, Uganda. AIDS 21:845–850

    Article  Google Scholar 

  11. Hallett TB, Singh K, Smith JA, White RG, Abu-Raddad LJ et al. (2008) Understanding the impact of male circumcision interventions on the spread of HIV in southern Africa. PLoS One 3:e2212. doi:10.1371/journal.pone.0002212

    Article  Google Scholar 

  12. White RG, Glynn JR, Orroth KK, Freeman EE, Bakker R et al. (2008) Male circumcision for HIV prevention in sub-Saharan Africa: who, what and when? AIDS 22:1841–1850

    Article  Google Scholar 

  13. Alsallaq R, Abu-Raddad L (2008) Male circumcision is a leading actor behind the differential HIV prevalence in sub-Saharan Africa [Poster MOPE0254]. In: Proceedings of the XVII international AIDS conference, Mexico City, Mexico. http://www.aids2008-abstracts.org/. Accessed 13 Aug 2009

  14. Kahn JG, Marseille E, Auvert B (2006) Cost effectiveness of male circumcision for HIV prevention in a South African setting. PLoS Med 3:e517. doi:10.1371/journal.pmed.0030517

    Article  Google Scholar 

  15. Auvert B, Marseille E, Korenromp EL, Lloyd-Smith J, Sitta R et al. (2008) Estimating the resources needed and savings anticipated from rollout of adult male circumcision in sub-Saharan Africa. PLoS One 3:e2679. doi:10.1371/journal.pone.0002679

    Article  Google Scholar 

  16. Bollinger L, Stover J, Musuka G et al. (2009) The cost and impact of male circumcision on HIV/AIDS in Botswana. J Int AIDS Soc 12:7. doi:10.11861/1758-2652-12-7

    Article  Google Scholar 

  17. Martin G, Bollinger L, Pandit-Rajani T, Tshehlo R, Nkambula R et al. (2007) Costing male circumcision in Lesotho, Swaziland, and Zambia: implications for the cost-effectiveness of circumcision as an HIV intervention. USAID Health Policy Initiative, Washington, DC. http://www.healthpolicyinitiative.com/Publications/Documents/419_1_Joint_MC_Costing_Technical_Report_FINAL2.pdf. Accessed 13 Aug 2009

  18. Binagwaho A, Pegurri E, Muita J, Bertozzi S (2010) Male circumcision at different ages in Rwanda: a cost-effectiveness study. PLoS Med 7(1):e1000211. doi:10.1371/journal.pmed.1000211

    Article  Google Scholar 

  19. Njeuhmeli E, Forsythe S, Reed J, Opuni M, Bollinger L et al. (2011) Voluntary medical male circumcision: modeling the impact and cost of expanding male circumcision for HIV prevention in eastern and Southern Africa. PLoS Med 8(11):e1001132. doi:http://10.1371/journal.pmed.1001132

    Google Scholar 

  20. Grant R (2010) Antiretroviral agents used by HIV-uninfected persons for prevention: pre- and post-exposure prophylaxis. Clin Infect Dis 50:96–101

    Article  Google Scholar 

  21. Braitstein P, Brinkhof M, Dabis F, Schechter M, Boulle A et al. (2006) Mortality of HIV-1-infected patients in the first year of antiretroviral therapy: comparison between low-income and high-income countries. Lancet 367:817–824

    Article  Google Scholar 

  22. Jahn A, Floyd S, Crampin A, Mwaungulu F, Mvula H et al. (2008) Population level effect of HIV on adult mortality and early evidence of reversal after introduction of antiretroviral therapy in Malawi. Lancet 371:1603–1611

    Article  Google Scholar 

  23. Guay L, Musoke P, Fleming T, Bagenda D, Allen M et al. (1999) Intrapartum and neonatal single-dose nevirapine compared with zidovudine for prevention of mother-to-child transmission of HIV-1 in Kampala, Uganda: HIVNET 012 randomised trial. Lancet 354:795–802

    Google Scholar 

  24. Abdool Karim Q, Abdool Karim SS, Frohlich JA, Grobler AC, Baxter C, Mansoor LE et al. (2010) Effectiveness and safety of tenofovir gel, an antiretroviral microbicide, for the prevention of HIV infection in women. Science 329:1168–1174

    Article  Google Scholar 

  25. Grant RM, Lama JR, Anderson PL, McMahan V, Liu AY, Vargas L et al. (2010) Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. N Engl J Med 363:2587–2599

    Article  Google Scholar 

  26. Pretorius C, Stover J, Bollinger L, Bacaer N, Williams B (2010) Evaluating the cost-effectiveness of pre-exposure prophylaxis (PrEP) and its impact on HIV-1 transmission in South Africa. PLoS One 5(11):e13646

    Article  Google Scholar 

  27. Bacaer N, Pretorius C, Auvert B (2010) An age-structured model for the potential impact of generalized access to antiretrovirals on the South African HIV epidemic. Bull Math Biol 72:2180–2198. doi:10.1007/s11538-010-9535-2

    Article  Google Scholar 

  28. Granich R, Gilks C, Dye C, De Cock K, Williams B (2009) Universal voluntary HIV testing with immediate antiretroviral therapy as a strategy for elimination of HIV transmission: a mathematical model. Lancet 373:48–57

    Article  Google Scholar 

  29. Donnell D, Baeten J, Kiarie J, Thomas K, Stevens W et al. (2010) Heterosexual HIV-1 transmission after initiation of antiretroviral therapy: a prospective cohort analysis. Lancet 375:2092–2098

    Article  Google Scholar 

  30. Cohen MS, Chen YQ, McCauley M, Gamble T, Hosseinipour MC, Kumarasamy N et al. (2011) Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med 365:493–505. doi:10.1056/NEJMoa1105243

    Article  Google Scholar 

  31. Abbas U, Anderson R, Mellors J (2007) Potential impact of antiretroviral chemoprophylaxis on HIV-1 transmission in resource-limited settings. PLoS One 2:e875

    Article  Google Scholar 

  32. Abbas U, Glaubius R, Mubayi A, Hood G, Mellors J (2011) Predicting the impact of ART and PrEP with overlapping regiments on HIV transmission and drug resistance in South Africa. Paper # 98LB, Presented at 18th conference on retroviruses and opportunistic infections, Boston

    Google Scholar 

  33. Global report UNAIDS (2010) UNAIDS report on the global AIDS epidemic 2010, Joint United Nations Programme on HIV/AIDS, Geneva

    Google Scholar 

  34. International AIDS Vaccine Initiative Database of AIDS vaccine candidates in clinical trials. International AIDS Vaccine Inititative, New York. www.iavi.org. Accessed 28 Mar 2011

  35. Future access to HIV vaccines UNAIDS (2001) Report from a WHO-UNAIDS Consultation, Geneva, 2–3 Oct 2000, 15:W27–W44

    Google Scholar 

  36. Francis DP, Heyward WL, Popovic V, Orozco-Cronin P, Orelind K, Gee C et al. (2003) Candidate HIV/AIDS vaccines: lessons learned from the World’s first phase III efficacy trials. AIDS 17:147–156

    Article  Google Scholar 

  37. Rerks-Ngarm S, Pitisuttithum P, Nitayaphan S, Kaewkungwal J, Chiu J, Paris R et al. (2009) Vaccination with ALVAC and AIDSVAX to prevent HIV-1 infection in Thailand. N Engl J Med 361:2209–2220

    Article  Google Scholar 

  38. Hankins C, Macklin R, Michael N, Stablein D and the participants at the March meeting in Bangkok Thailand Recommendations for the future utility of the RV144 vaccines to the Thai Ministry of Health. Report on meeting in Bangkok, Thailand 16–18 Mar 2010, Global HIV Vaccine Enterprise, WHO-UNAIDS, Thai Ministry of Public Health, and U.S. Military HIV Research Program, Bangkok. http://www.vaccineenterprise.org/sites/default/files/RV144_March16-18_Meeting_Report_FINAL.pdf. Accessed 14 Feb 2011

  39. Bollinger L, Stover J, Forsythe S (2009) Estimating long-term global resource needs for AIDS through 2031. Results for Development Institute, Futures Institute, and the aids2031 Costs and Financing Working Group, Glastonbury, CT. http://www.resultsfordevelopment.org/publications/estimating-long-term-global-resource-needs-aids-through-2031. Accessed 14 Feb 2011

  40. Fonseca MGP, Forsythe S, Menezes A, Vuthoori S, Possas C, Veloso V et al. (2010) Modeling HIV vaccines in Brazil: assessing the impact of a future HIV vaccine on reducing new infections, mortality and number of people receiving ARV. PLoS One 5:e11736

    Article  Google Scholar 

  41. International AIDS Vaccine Initiative(a) (2009) Uganda: estimating the potential impact of an AIDS vaccine. Policy Brief 23. International AIDS Vaccine Initiative, New York. http://www.iavi.org/publications-resources/Pages/PublicationDetail.aspx?pubID=454d7f8e-f58a-4bf0%979694%9736447fa52211. Accessed 12 Feb 2011

  42. International AIDS Vaccine Initiative(a) (2009) Kenya: estimating the potential impact of an AIDS vaccine. Policy Brief 24. International AIDS Vaccine Initiative, New York. http://www.iavi.org. Accessed 12 Feb 2011

  43. Stover J, Bollinger L, Hecht R, Williams C, Roca E (2007) The impact of an AIDS vaccine in developing countries: a new model and initial results. Health Aff 26:1147–1158

    Article  Google Scholar 

  44. Hecht R, Stover J, Bollinger L, Muhib F, Case K, de Ferranti D (2010) Financing of HIV/AIDS programme scale-up in low-income and middle-income countries, 2009–31. Lancet 376:1254–1260

    Article  Google Scholar 

  45. Bollinger L, Stover J (2006) HIV vaccine: a model for examining the effects of an HIV vaccine. Futures Institute, Glastonbury, CT. http://futuresinstitute.org/Download/Spectrum/Manuals/Vaccine%20Manual.pdf. Accessed 12 Feb 2011

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Authors and Affiliations

  1. Futures Institute, Glastonbury, CT, USA

    John Stover, Carel Pretorius & Kyeen Andersson

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  1. John Stover
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  2. Carel Pretorius
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  3. Kyeen Andersson
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Correspondence to John Stover .

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  1. , Ivey School of Business, University of Western Ontario, London, N6A 3K7, Ontario, Canada

    Gregory S. Zaric

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Stover, J., Pretorius, C., Andersson, K. (2013). Modeling the Impact of New HIV Prevention Technologies in Sub-Saharan Africa. In: Zaric, G. (eds) Operations Research and Health Care Policy. International Series in Operations Research & Management Science, vol 190. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-6507-2_9

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