ArticleAIDS (London, England)2013
Can the UNAIDS modes of transmission model be improved? A comparison of the original and revised model projections using data from a setting in west Africa.
Article in AIDS (London, England), 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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15 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.
- The HIV Modes of Transmission model: a systematic review of its findings and adherence to guidelines.Journal of the International AIDS Society · 2014Pooled it
- Using a Programme Science approach to substantially reduce the risk of HIV transmission and acquisition in sex transactions among female sex workers in Zimbabwe.Journal of the International AIDS Society · 2024Article
- Estimating the Population Size of Female Sex Workers in Zimbabwe: Comparison of Estimates Obtained Using Different Methods in Twenty Sites and Development of a National-Level Estimate.Journal of acquired immune deficiency syndromes (1999) · 2020Article
- The contributions and future direction of Program Science in HIV/STI prevention.Emerging themes in epidemiology · 2018Article
- Changing Dynamics of HIV Transmission in Côte d'Ivoire: Modeling Who Acquired and Transmitted Infections and Estimating the Impact of Past HIV Interventions (1976-2015).Journal of acquired immune deficiency syndromes (1999) · 2017Article
- The Incidence Patterns Model to Estimate the Distribution of New HIV Infections in Sub-Saharan Africa: Development and Validation of a Mathematical Model.PLoS medicine · 2016Article
- Data and methods to characterize the role of sex work and to inform sex work programs in generalized HIV epidemics: evidence to challenge assumptions.Annals of epidemiology · 2016Review
- PrEP implementation research in Africa: what is new?Journal of the International AIDS Society · 2016Article
- Evaluating respondent-driven sampling as an implementation tool for universal coverage of antiretroviral studies among men who have sex with men living with HIV.Journal of acquired immune deficiency syndromes (1999) · 2015Article
- Article
- Pre-exposure prophylaxis in Southern Africa: feasible or not?Journal of the International AIDS Society · 2015Article
- PrEP Implementation Science: State-of-the-Art and Research Agenda.Journal of the International AIDS Society · 2015Article
- Redefining the HIV epidemic in Nigeria: from national to state level.AIDS (London, England) · 2014Article
- Article
- Validation of the modes of transmission model as a tool to prioritize HIV prevention targets: a comparative modelling analysis.PloS one · 2014Article
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Authors and funding
9 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe UNAIDS modes of transmission model (MoT) is a user-friendly model, developed to predict the distribution of new HIV infections among different subgroups. The model has been used in 29 countries to guide interventions. However, there is the risk that the simplifications inherent in the MoT produce misleading findings. Using input data from Nigeria, we compare projections from the MoT with those from a revised model that incorporates additional heterogeneity.
methodsWe revised the MoT to explicitly incorporate brothel and street-based sex-work, transactional sex, and HIV-discordant couples. Both models were parameterized using behavioural and epidemiological data from Cross River State, Nigeria. Model projections were compared, and the robustness of the revised model projections to different model assumptions, was investigated.
resultsThe original MoT predicts 21% of new infections occur in most-at-risk-populations (MARPs), compared with 45% (40-75%, 95% Crl) once additional heterogeneity and updated parameterization is incorporated. Discordant couples, a subgroup previously not explicitly modelled, are predicted to contribute a third of new HIV infections. In addition, the new findings suggest that women engaging in transactional sex may be an important but previously less recognized risk group, with 16% of infections occurring in this subgroup.
conclusionThe MoT is an accessible model that can inform intervention priorities. However, the current model may be potentially misleading, with our comparisons in Nigeria suggesting that the model lacks resolution, making it challenging for the user to correctly interpret the nature of the epidemic. Our findings highlight the need for a formal review of the MoT.
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