The Impact of Past HIV Interventions and Diagnosis Gaps on New HIV Acquisitions, Transmissions, and HIV-related Deaths in Côte D'Ivoire, Mali, and Senegal

Overview

Journal AIDS

Specialty Infectious Diseases

Date 2024 Jul 2

PMID 38953898

Authors

Romain Silhol

Mathieu Maheu-Giroux

Nirali Soni

Arlette Simo Fotso

Nicolas Rouveau

Anthony Vautier

Clemence Doumenc-Aidara

Olivier Geoffroy

Kouassi Noel Nguessan

Younoussa Sidibe

Ode Kanku Kabemba

Papa Alioune Gueye

Pauline Dama Ndeye

Christinah Mukandavire

Peter Vickerman

Abdelaye Keita

Cheikh Tidiane Ndour

Eboi Ehui

Joseph Larmarange

Marie-Claude Boily

Affiliations

Soon will be listed here.

Abstract

Objectives: To estimate the epidemiological impact of past HIV interventions and the magnitude and contribution of undiagnosed HIV among different risk groups on new HIV acquisitions in Côte d'Ivoire, Mali and Senegal.

Design: HIV transmission dynamic models among the overall population and key populations [female sex workers (FSW), their clients, and MSM].

Methods: Models were independently parameterized and calibrated for each set of country-specific demographic, behavioural, and epidemiological data. We estimated the fraction of new HIV infections over 2012-2021 averted by condom use and antiretroviral therapy (ART) uptake among key populations and non-key populations, the direct and indirect contribution of specific groups to new infections [transmission population-attributable fraction (tPAF)] over 2012-2021 due to prevention gaps, and the distribution of undiagnosed people with HIV (PWH) by risk group in January 2022 and their tPAF over 2022-2031.

Results: Condom use and ART may have averted 81-88% of new HIV infections over 2012-2021 across countries, mostly due to condom use by key population. The tPAF of all key populations combined over 2012-2021 varied between 27% (Côte d'Ivoire) and 79% (Senegal). Male key populations (clients of FSW and MSM) contributed most to new infections (>60% in Mali and Senegal) owing to their higher HIV prevalence and larger prevention gaps. In 2022, men represented 56% of all PWH with an undiagnosed infection in Côte d'Ivoire (male key populations = 15%), 46% in Mali (male key populations = 23%), and 69% in Senegal (male key populations = 55%). If HIV testing and ART initiation rates remain at current levels, 20% of new HIV infections could be due to undiagnosed key populations living with HIV in Côte d'Ivoire over 2022-2031, 53% in Mali, and 65% in Senegal.

Conclusion: Substantial HIV diagnosis gaps remain in Western Africa, especially among male key populations. Addressing these gaps is key to impacting the HIV epidemics in the region and achieving the goal of ending AIDS by 2030.

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