Evidence map›Paper›PMID 30033604›Full record

ArticleJournal of the International AIDS Society2018

Estimating the contribution of key populations towards the spread of HIV in Dakar, Senegal.

Christinah Mukandavire, Josephine Walker, Sheree Schwartz, Marie-Claude Boily, Leon Danon, Carrie Lyons, Daouda Diouf, Ben Liestman, Nafissatou Leye Diouf, Fatou Drame and 10 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the International AIDS Society, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
27citing papers in PubMed, 3 pooled it
4.0field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

27 citing papers in PubMed, 3 syntheses or guidelines pooled it, 42 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors at 8 institutions in 6 countries.

Christinah MukandavirePopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Josephine WalkerPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Sheree SchwartzDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Marie-Claude BoilyDepartment of Infectious Disease Epidemiology, Imperial College, London, UK.
Leon DanonPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Carrie LyonsDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Daouda DioufEnda Sante, Dakar, Senegal.
Ben LiestmanDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Nafissatou Leye DioufInstitut de Recherche en Santé, de Surveillance Epidemiologique et de Formations, Dakar, Senegal.
Fatou DrameEnda Sante, Dakar, Senegal.
Karleen ColyDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Remy Serge Manzi MuhireDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Safiatou ThiamDepartment of Health, National AIDS Council of Senegal, Dakar, Senegal.
Papa Amadou Niang DialloDivision de La Lutte Contre Le Sida et Les IST, Ministry of Health, Dakar, Senegal.
Coumba Toure KaneInstitut de Recherche en Santé, de Surveillance Epidemiologique et de Formations, Dakar, Senegal.
Cheikh NdourDivision de La Lutte Contre Le Sida et Les IST, Ministry of Health, Dakar, Senegal.
Erik VolzDepartment of Infectious Disease Epidemiology, Imperial College, London, UK.
Sharmistha MishraSt Michaels Hospital, University of Toronto, Toronto, Canada.
Stefan BaralDepartment of Infectious Disease Epidemiology, Imperial College, London, UK.
Peter VickermanPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Johns Hopkins University · USUniversity of Bristol · GBImperial College London · GBComité National de Lutte contre le SIDA · CMEnvironment and Development Action Third World · SNInstitute of Health Research, Epidemiological Surveillance and Training · SNNational AIDS Council · ZWSt. Michael's Hospital · CA

Funding

Vaccine Response and Immunotherapeutics SWGP30AI094189 · NIAID · JOHNS HOPKINS UNIVERSITY · PI Richard E. Chaisson · 2012 to 2026
$67.0M
Department of HealthMedical Research Council MR/R015600/1NIAID NIH HHS P30 AI094189PEPFAR
6 · The paper itself

Abstract

introductionKey populations including female sex workers (FSW) and men who have sex with men (MSM) bear a disproportionate burden of HIV. However, the role of focusing prevention efforts on these groups for reducing a country's HIV epidemic is debated. We estimate the extent to which HIV transmission among FSW and MSM contributes to overall HIV transmission in Dakar, Senegal, using a dynamic assessment of the population attributable fraction (PAF).

methodsA dynamic transmission model of HIV among FSW, their clients, MSM and the lower-risk adult population was parameterized and calibrated within a Bayesian framework using setting-specific demographic, behavioural, HIV epidemiological and antiretroviral treatment (ART) coverage data for 1985 to 2015. We used the model to estimate the 10-year PAF of commercial sex between FSW and their clients, and sex between men, to overall HIV transmission (defined as the percentage of new infections prevented when these modes of transmission are removed). In addition, we estimated the prevention benefits associated with historical increases in condom use and ART uptake, and impact of further increases in prevention and treatment.

resultsThe model projections suggest that unprotected sex between men contributed to 42% (2.5 to 97.5th percentile range 24 to 59%) of transmissions between 1995 and 2005, increasing to 64% (37 to 79%) from 2015 to 2025. The 10-year PAF of commercial sex is smaller, diminishing from 21% (7 to 39%) in 1995 to 14% (5 to 35%) in 2015. Without ART, 49% (32 to 71%) more HIV infections would have occurred since 2000, when ART was initiated, whereas without condom use since 1985, 67% (27 to 179%) more HIV infections would have occurred, and the overall HIV prevalence would have been 60% (29 to 211%) greater than what it is now. Further large decreases in HIV incidence (68%) can be achieved by scaling up ART in MSM to 74% coverage and reducing their susceptibility to HIV by two-thirds through any prevention modality.

conclusionsUnprotected sex between men may be an important contributor to HIV transmission in Dakar, due to suboptimal coverage of evidence-informed interventions. Although existing interventions have effectively reduced HIV transmission among adults, it is crucial that further strategies address the unmet need among MSM.

Indexed as

Homosexuality, MaleSex WorkersAdolescentAdultAnti-HIV AgentsAnti-Retroviral AgentsBayes TheoremCondomsEpidemicsFemaleHIV InfectionsHumansMaleMiddle AgedModels, BiologicalPrevalenceAnti-HIV AgentsAnti-Retroviral Agentsclientscondom usefemale sex workersHIVkey populationsmen who have sex with menpopulation attributable fraction

Identifiers

PMID30033604
PMCPMC6055131
OpenAlexW2883320890

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.