title: A practical online tool to estimate antiretroviral coverage for HIV infected and susceptible populations needed to reduce local HIV epidemics.
abstract: It remains unclear what proportions of HIV-infected and uninfected people should receive effective antiretroviral therapy (ART) to control local HIV epidemics. We developed a flexible model to evaluate the impact of treatment as prevention (TasP) and pre-exposure prophylaxis (PrEP) on HIV incidence in local communities. We evaluated this tool for determining what TasP and PrEP targets are needed to substantially reduce the HIV epidemic in San Diego, which is predominately comprised of men who have sex with men. By increasing the proportion of HIV-infected individuals on ART from 30% to 50%, 686 new infections would be prevented over five years in San Diego. By providing PrEP to 30% of MSM to the age group that account for 90% of local HIV incident cases (21-52 years), we could prevent 433 infections over five years. When combining these initiatives, a PrEP coverage rate of 40% and TasP coverage rate of 34% would be expected to decrease the number of new infections by over half in one year. This online tool is designed to help local public health planners and policy makers to estimate program outcomes and costs that may lead to better control of their local HIV epidemics.
authors.affiliation: Division of Infectious Diseases, University of California, San Diego, La Jolla, California, United States of America.
authors.forename: Antoine
authors.initials: A
authors.lastname: Chaillon
authors.affiliation: Division of Infectious Diseases, University of California, San Diego, La Jolla, California, United States of America.|Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Graz, Austria.|Division of Pulmonology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
authors.forename: Martin
authors.initials: M
authors.lastname: Hoenigl
authors.affiliation: Division of Infectious Diseases, University of California, San Diego, La Jolla, California, United States of America.|Veterans Affairs San Diego Healthcare System, San Diego, California, United States of America.
authors.forename: Sanjay R
authors.initials: SR
authors.lastname: Mehta
authors.affiliation: Department of Computer Science and Engineering, University of California San Diego, California, United States.
authors.forename: Nadir
authors.initials: N
authors.lastname: Weibel
authors.affiliation: Division of Infectious Diseases, University of California, San Diego, La Jolla, California, United States of America.
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Little
authors.affiliation: Division of Infectious Diseases, University of California, San Diego, La Jolla, California, United States of America.|Veterans Affairs San Diego Healthcare System, San Diego, California, United States of America.
authors.forename: Davey M
authors.initials: DM
authors.lastname: Smith
mesh_terms: D000328:Adult; D000367:Age Factors; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D002140:California / Q000453:epidemiology; D004198:Disease Susceptibility / Q000453:epidemiology; D058872:Epidemics; D015658:HIV Infections / Q000453:epidemiology* / Q000517:prevention & control*; D006291:Health Policy; D018451:Homosexuality, Male; D006801:Humans; D015994:Incidence; D020407:Internet; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D065129:Pre-Exposure Prophylaxis; D012309:Risk-Taking; D012680:Sensitivity and Specificity; D012725:Sexual Behavior; D055815:Young Adult
chemical_list: D044966:Anti-Retroviral Agents