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Disproportionate Impact of Combination Antiretroviral Therapy on AIDS Incidence in Australia: Results from a Modified Back-projection Model

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Abstract

The objective of the current study is to describe the impact of Combination antiretroviral therapy (cART) on trends in AIDS incidence over time for selected population groups in Australia, specifically, men who have sex with men (MSM) and injecting drug users (IDUs). A modified back-projection modeling technique was used to predict the number of AIDS diagnoses without cART based on Australia’s HIV/AIDS surveillance system database. Modelled estimates indicate that since 1996, the effective cART has reduced overall AIDS cases by ~70 and ~10% among MSM and IDUs respectively. The predicted reduction in AIDS cases among IDUs aged less than 40 years was 36% while there was no reduction predicted for those aged 40 years or older. The impact of cART on AIDS diagnoses has been modest among IDUs. Late presentation, poor access to health services and barriers to uptake of cART may account for the divergence between these population groups.

Resumen

El objetivo del estudio corriente es describir el impacto de Combinación antiretroviral terapia (carro) en tendencias en el frecuencia de SIDA con el tiempo para grupos demográficos seleccionados en Australia, expresamente, hombres que tienen el sexo con hombres (MSM) e inyectando a usuarios de medicina (IDUs). Una espalda-proyección modificada que modela la técnica fue usada para predecir el número de diagnósticos de SIDA sin el carro basado en la base de datos de sistema de vigilancia de VIH/SIDA de Australia. Las estimaciones modeladas indican que desde 1996, el carro eficaz ha reducido casos de SIDA totales en el ~70% y el ~10% entre MSM e IDUs respectivamente. La reducción predicha de casos de SIDA entre IDUs envejeció menos de 40 años era el 36% mientras no había ninguna reducción predicha durante aquellos 40 años ancianos o más vieja. El impacto de carro en diagnósticos de SIDA ha sido modesto entre IDUs. La presentación tardía, acceso pobre a Seguridad Social y barreras al consumo del carro puede explicar la divergencia entre estos grupos demográficos.

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Authors and Affiliations

  1. The Kirby Institute (formerly National Centre in HIV Epidemiology and Clinical Research), Level 2, CC4 East Wing, UNSW Cliffbrook Campus, Sydney, NSW, Australia

    Handan Wand, Kathleen Falster, David Wilson, Matthew Law & Lisa Maher

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  1. Handan Wand
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  2. Kathleen Falster
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  3. David Wilson
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  4. Matthew Law
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  5. Lisa Maher
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Correspondence to Handan Wand.

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Wand, H., Falster, K., Wilson, D. et al. Disproportionate Impact of Combination Antiretroviral Therapy on AIDS Incidence in Australia: Results from a Modified Back-projection Model. AIDS Behav 16, 360–367 (2012). https://doi.org/10.1007/s10461-011-9969-z

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