ArticleInternational health2016
Age-targeted HIV treatment and primary prevention as a 'ring fence' to efficiently interrupt the age patterns of transmission in generalized epidemic settings in South Africa.
Article in International health, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed.
- Projected burden of hypertension-associated cardiovascular disease in people living with HIV versus HIV-negative adults in Eswatini.medRxiv : the preprint server for health sciences · 2026Article
- Cost-Effectiveness of Differentiated Service Delivery for HIV Treatment: A Combined Mathematical Modeling Study of Four African Settings.Open forum infectious diseases · 2026Article
- Cost-Effectiveness Analyses of Adolescent- and Young-Adult-Focused HIV Interventions Incorporating HIV Transmission: a Scoping Review of Modeling Methods and Proposed Guidance.PharmacoEconomics - open · 2025Review
- Impacts of US Bilateral Aid Disruptions on HIV Resurgence in Zambia: A Mathematical Modeling Study.Open forum infectious diseases · 2025Article
- Estimated contributions and future mitigation strategies for HIV risk around funeral practices in western Kenya: a mathematical modeling study.BMC medicine · 2025Article
- Article
- Cost-effectiveness of voluntary medical male circumcision for HIV prevention across sub-Saharan Africa: results from five independent models.The Lancet. Global health · 2023Article
- Cost-effectiveness of the dual prevention pill for contraception and HIV pre-exposure prophylaxis.Frontiers in reproductive health · 2023Article
- Mapping age- and sex-specific HIV prevalence in adults in sub-Saharan Africa, 2000-2018.BMC medicine · 2022Article
- Transmission reduction, health benefits, and upper-bound costs of interventions to improve retention on antiretroviral therapy: a combined analysis of three mathematical models.The Lancet. Global health · 2022Article
- Factors associated with HIV testing among traditional healers and their clients in rural Uganda: Results from a cross-sectional study.International journal of STD & AIDS · 2021Article
- Article
- Early Treatment of COVID-19 Disease: A Missed Opportunity.Infectious diseases and therapy · 2020Article
- Article
- Large benefits to youth-focused HIV treatment-as-prevention efforts in generalized heterosexual populations: An agent-based simulation model.PLoS computational biology · 2019Article
- Cost-effectiveness of HIV Prevention Interventions in Sub-Saharan Africa: A Systematic Review.EClinicalMedicine · 2019Article
- Implementation and applications of EMOD, an individual-based multi-disease modeling platform.Pathogens and disease · 2018Article
- Development of an oral once-weekly drug delivery system for HIV antiretroviral therapy.Nature communications · 2018Article
- The influence of mobility among high-risk populations on HIV transmission in Western Kenya.Infectious Disease Modelling · 2018Article
- Universal test, treat, and keep: improving ART retention is key in cost-effective HIV control in Uganda.BMC infectious diseases · 2017Article
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundGeneralized HIV epidemics propagate to future generations according to the age patterns of transmission. We hypothesized that future generations could be protected from infection using age-targeted prevention, analogous to the ring-fencing strategies used to control the spread of smallpox.
methodsWe modeled age-targeted or cohort-targeted outreach with HIV treatment and/or prevention using EMOD-HIV v0·8, an individual-based network model of HIV transmission in South Africa.
resultsTargeting ages 20 to 30 with intensified outreach, linkage, and eligibility for antiretroviral therapy (ART) averted 45% as many infections as universal outreach for approximately one-fifth the cost beyond existing HIV services. Though cost-effective, targeting failed to eliminate all infections to those under 20 due to vertical and inter-generational transmission. Cost-effectiveness of optimal prevention strategies included US$6238 per infection averted targeting ages 10-30, US$5031 targeting 20-30, US$4279 targeting 22-27, and US$3967 targeting 25-27, compared to US$10 812 for full-population test-and-treat. Minimizing burden (disability-adjusted life years [DALYs]) rather than infections resulted in older target age ranges because older adults were more likely to receive a direct health benefit from treatment.
conclusionsAge-targeted treatment for HIV prevention is unlikely to eliminate HIV epidemics, but is an efficient strategy for reducing new infections in generalized epidemics settings.
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