title: Preventing HIV Transmission Among Partners of HIV-Positive Male Sex Workers in Mexico City: A Modeling Study.
abstract: Mexico has a concentrated HIV epidemic, with male sex workers constituting a key affected population. We estimated annual HIV cumulative incidence among male sex workers' partners, and then compared incidence under three hypothetical intervention scenarios: improving condom use; and scaling up HIV treatment as prevention, considering current viral suppression rates (CVS, 60.7 %) or full viral suppression among those treated (FVS, 100 %). Clinical and behavioral data to inform model parameterization were derived from a sample (n = 79) of male sex workers recruited from street locations and Clínica Condesa, an HIV clinic in Mexico City. We estimated annual HIV incidence among male sex workers' partners to be 8.0 % (95 % CI: 7.3-8.7). Simulation models demonstrated that increasing condom use by 10 %, and scaling up HIV treatment initiation by 50 % (from baseline values) would decrease the male sex workers-attributable annual incidence to 5.2, 4.4 % (CVS) and 3.2 % (FVS), respectively. Scaling up the number of male sex workers on ART and implementing interventions to ensure adherence is urgently required to decrease HIV incidence among male sex workers' partners in Mexico City.
authors.affiliation: School of Public Health, Brown University, 121 South Main Street, Box G-121S-7, Providence, RI, 02912, USA.
authors.forename: João Filipe G
authors.initials: JF
authors.lastname: Monteiro
authors.forename: Brandon D L
authors.initials: BD
authors.lastname: Marshall
authors.forename: Daniel
authors.initials: D
authors.lastname: Escudero
authors.forename: Sandra G
authors.initials: SG
authors.lastname: Sosa-Rubí
authors.forename: Andrea
authors.initials: A
authors.lastname: González
authors.forename: Timothy
authors.initials: T
authors.lastname: Flanigan
authors.forename: Don
authors.initials: D
authors.lastname: Operario
authors.forename: Kenneth H
authors.initials: KH
authors.lastname: Mayer
authors.forename: Mark N
authors.initials: MN
authors.lastname: Lurie
authors.forename: Omar
authors.initials: O
authors.lastname: Galárraga
mesh_terms: D000293:Adolescent; D000328:Adult; D017280:Condoms / Q000706:statistics & numerical data*; D058872:Epidemics; D015658:HIV Infections / Q000517:prevention & control* / Q000635:transmission; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D018451:Homosexuality, Male; D006801:Humans; D015994:Incidence; D008297:Male; D008800:Mexico / Q000453:epidemiology; D009010:Monte Carlo Method; D012307:Risk Factors; D021841:Safe Sex; D060386:Sex Workers; D012747:Sexual Partners