title: Evaluating the Impact of Test-and-Treat on the HIV Epidemic among MSM in China Using a Mathematical Model.
abstract: BACKGROUND
  Various studies have modeled the impact of test-and-treat policies on the HIV epidemics worldwide. However, few modeling studies have taken into account China's context. To understand the potential effect of test-and-treat on the HIV epidemic among men who have sex with men (MSM) in China, we developed a mathematical model to evaluate the impact of the strategy.
  
  
  METHODS
  Based on the natural history of the CD4 count of people living with HIV and AIDS (PLWHA), we constructed a dynamic compartmental model of HIV transmission among Chinese MSM to project the number of HIV new infections and prevalence over 10 years. We predicted the annual number of HIV new infections and the total number of MSM living with HIV and AIDS (based on Beijing data) between 2010 and 2022 under the following conditions: (1) current practice (testing rate of 50% and ART coverage of 39%); (2) both testing rate and ART coverage increasing to 70% in 2013; (3) both testing rate and ART coverage increasing to 90% in 2013; and (4) both testing rate and ART coverage increasing gradually every year until 90% since 2013.
  
  
  RESULTS
  Based on our model, if the HIV test-and-treat policy was implemented among Chinese MSM, the total number of HIV new infections over 10 years (2013-2022) would be reduced by 50.6-70.9% compared with the current policy. When ART coverage for PLWHA increased to 58% since 2013, the 'turning point' would occur on the curve of HIV new infections by 2015. A 25% reduction in annual number of HIV new infections by 2015 might be achieved if the testing rate increased from 50% to 70% and treatment coverage for PLWHA increased to 55% since 2013.
  
  
  CONCLUSIONS
  Implementation of the test-and-treat strategy may significantly reduce HIV new infections among MSM in China. Great efforts need to be made to scale up HIV testing rate and ART coverage among Chinese MSM.
authors.affiliation: Division of Prevention Intervention, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China; Department of Epidemiology and Biostatistics, Peking Union Medical College, Beijing, China.
authors.forename: Sitong
authors.initials: S
authors.lastname: Luo
authors.affiliation: School of Information, Renmin University of China, Beijing, China.
authors.forename: Litao
authors.initials: L
authors.lastname: Han
authors.affiliation: Institute for AIDS/STD Control and Prevention, Beijing Center for Disease Control and Prevention, Beijing, China.
authors.forename: Hongyan
authors.initials: H
authors.lastname: Lu
authors.affiliation: Division of Prevention Intervention, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
authors.forename: Zhi
authors.initials: Z
authors.lastname: Dou
authors.affiliation: School of Information, Renmin University of China, Beijing, China.
authors.forename: Qian
authors.initials: Q
authors.lastname: Tao
authors.affiliation: Department of Epidemiology of Microbial Diseases, Yale University, New Haven, Connecticut, United States of America.
authors.forename: Kaveh
authors.initials: K
authors.lastname: Khoshnood
authors.affiliation: Division of Prevention Intervention, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
authors.forename: Zunyou
authors.initials: Z
authors.lastname: Wu
authors.affiliation: Division of Prevention Intervention, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Xu
mesh_terms: D002681:China / Q000453:epidemiology; D015658:HIV Infections / Q000453:epidemiology* / Q000635:transmission*; D015497:HIV-1; D006716:Homosexuality; D006801:Humans; D008297:Male; D008954:Models, Biological