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Impact of Antiretroviral Therapy on the Spread of Human Immunodeficiency Virus in Chaoyang District, Beijing, China： Using the asian epidemic model

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Chinese Medical Journal 2017年第1期130卷 32-38页

作者： Li-Li Tao Min Liu Shu-Ming Li Jue Liu Shu-Lin Jiang Li-Juan Wang Feng-Ji Luo Ning Wang Department of Epidemiology and Biostatistics School of Public Health Peking University Beijing 100191 China Department of STD and AIDS Prevention and Control Beijing Chaoyang District Centre for Disease Control and Prevention Beijing 100021 China National Center for AIDS/STD Control and Prevention Chinese Center for Disease Control and Prevention Beijing 102206 China

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. Conclusion： 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.

关键词： Antiretroviral Therapy asian epidemic model Human Immunodeficiency Virus Impact Transmission

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The Changing Trends of HIV/AIDS in An Ethnic Minority Region of China: modeling the epidemic in Liangshan Prefecture, Sichuan Province

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Biomedical and Environmental Sciences 2013年第7期26卷 562-570页

作者： LIU Shou WANG Qi Xing NAN Lei WU Chun Lin WANG Zhao Fen BAI Zhen Zhong LIU Li CAI Peng QIN Si LUAN Rong Sheng Department of Epidemiology West China School of Public Health Sichuan University Department of Epidemiology Medical College of Qinghai University Center for Disease Control and Prevention of Liangshan Prefecture Chengdu Cancer Hospital Research Center for High Altitude Medicine Medical College of Qinghai University Center for Disease Control and Prevention of Sichuan Province

Objective This study was to investigate the HIV current situation in Liangshan prefecture, in order to predict prevalence and transmission trends. Methods Region-specific population, behavior, serosurveillence, and policy/program data （from 1995 to 2020） were gathered from various local and national organizations and applied to the asian epidemic model （AEM） and used to derive estimates of future HIV prevalence, epidemic trends, and outcomes of intervention strategies. Results The AEM projections for 2020 included increased number of people living with HIV （PLHIV; to 136 617）, increased HIV prevalence （2.51%）, and 8037 deaths from acquired immunodeficiency syndrome （AIDS） in this region. However, the overall HIV incidence rate （per 10 000） was projected to decline from 27 in 2015 to 22 in 2020, largely due to a predicted decrease in HIV infection rate （per 10 000） from 658 in 2013 to 621 in 2020 among intravenous drug users. In contrast, the cases of HIV infection per i0 000 was projected to increase from 420 in 2010 to 503 in 2020 among men who have sex with men, and from 8 in 2010 to 15 in 2020 among the general population. The predominant risk factor for HIV transmission over the next decade in Liangshan was casual sex. Community-based outreach strategies to reduce injected drug use and casual sex, and to promote condom use, were predicted as effective interventions to decrease HIV transmission. Conclusion Implementation of a comprehensive public health program, with targeting to the region-specific at-risk populations, will help to mitigate HIV/AIDS spread in Liangshan.

关键词： HIV/AIDS asian epidemic model High-risk population Liangshan Prefecture

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