title: Impact of Antiretroviral Therapy on the Spread of Human Immunodeficiency Virus in Chaoyang District, Beijing, China: Using the Asian Epidemic Model.
abstract: BACKGROUND
  Successful antiretroviral therapy (ART) has been demonstrated to be effective in reducing the infectivity of human immunodeficiency virus (HIV). We conducted a study to predict the potential effect of ART on the spread of HIV in Chaoyang District, Beijing, China, using the Asian Epidemic Model (AEM).
  
  
  METHODS
  The AEM baseline workbook was used to determine the current infection status and to project the future spread of HIV under current conditions. We changed the input on the ART coverage from 2014 to 2025 and also modified the treatment eligibility in the AEM intervention workbook, in order to allow for analysis of the projected downstream impact of ART.
  
  
  RESULTS
  By gradually increasing the ART coverage rate from 29.7% (rate of 2013) to 40.0%, 50.0%, 60.0%, 70.0%, 80.0%, and 90.0% (at CD4+ ≤350 cells/μl), and by changing the dates of coverage from 2014 to 2020, the number of new infections showed a cumulative decline of 0.60%, 1.59%, 2.94%, 5.33%, 9.32%, and 14.98%, respectively. After 2020, the projected rates of infection rebounded slightly, so with the exception of the years with very high coverage (90.0%), new infections continued to decrease. When we changed the initial threshold of therapy to CD4+ cell counts ≤500 cells/μl, new infections decreased 6.00%, 11.64%, 15.92%, 21.11%, 26.92%, 33.05%, and 38.75%, respectively, under varying ART coverages.
  
  
  CONCLUSIONS
  Our study demonstrates that the early initiation of ART for people living with HIV/acquired immune deficiency syndrome (AIDS) has a positive effect in slowing the spread of HIV.
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China.
authors.forename: Li-Li
authors.initials: LL
authors.lastname: Tao
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China.
authors.forename: Min
authors.initials: M
authors.lastname: Liu
authors.affiliation: Department of STD and AIDS Prevention and Control, Beijing Chaoyang District Centre for Disease Control and Prevention, Beijing 100021, China.
authors.forename: Shu-Ming
authors.initials: SM
authors.lastname: Li
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China.
authors.forename: Jue
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of STD and AIDS Prevention and Control, Beijing Chaoyang District Centre for Disease Control and Prevention, Beijing 100021, China.
authors.forename: Shu-Lin
authors.initials: SL
authors.lastname: Jiang
authors.affiliation: Department of STD and AIDS Prevention and Control, Beijing Chaoyang District Centre for Disease Control and Prevention, Beijing 100021, China.
authors.forename: Li-Juan
authors.initials: LJ
authors.lastname: Wang
authors.affiliation: Department of STD and AIDS Prevention and Control, Beijing Chaoyang District Centre for Disease Control and Prevention, Beijing 100021, China.
authors.forename: Feng-Ji
authors.initials: FJ
authors.lastname: Luo
authors.affiliation: National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
authors.forename: Ning
authors.initials: N
authors.lastname: Wang
mesh_terms: D023241:Antiretroviral Therapy, Highly Active / Q000379:methods; D000068476:Beijing; D018791:CD4 Lymphocyte Count; D002681:China / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000635:transmission*; D006801:Humans; D008297:Male; D008962:Models, Theoretical; D017678:Sex Distribution