ArticleJournal of the International AIDS Society2021
Modelling the impact of HIV and HCV prevention and treatment interventions for people who inject drugs in Dar es Salaam, Tanzania.
Article in Journal of the International AIDS Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 9 citations in OpenAlex.
- Article
- Hepatitis C virus transmission among people who inject drugs in the Middle East and North Africa: mathematical modeling analyses of incidence and intervention impact.EClinicalMedicine · 2025Article
- People Who Inject Drugs in Mozambique: We need to normalize HIV treatment and care services in specialized community centers for people who inject drugs!Harm reduction journal · 2024Article
- Comparison of Empirically Derived and Model-Based Estimates of Key Population HIV Incidence and the Distribution of New Infections by Population Group in Sub-Saharan Africa.Journal of acquired immune deficiency syndromes (1999) · 2024Article
- Modeling the Impacts of Prevention and Treatment Interventions on Hepatitis C Among People Who Inject Drugs in China.Infectious diseases and therapy · 2023Article
- Awareness and willingness to use HIV oral pre-exposure prophylaxis among people who inject drugs in Dar es Salaam, Tanzania: A cross-sectional survey.PLOS global public health · 2022Article
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Authors and funding
15 authors at 6 institutions in 5 countries.
Funding
Abstract
introductionPeople who inject drugs (PWID) in Dar es Salaam, Tanzania, have a high prevalence of HIV and hepatitis C virus (HCV). While needle and syringe programmes (NSP), opioid agonist therapy (OAT) and anti-retroviral therapy (ART) are available in Tanzania, their coverage is sub-optimal. We assess the impact of existing and scaled up harm reduction (HR) interventions on HIV and HCV transmission among PWID in Dar es Salaam.
methodsAn HIV and HCV transmission model among PWID in Tanzania was calibrated to data over 2006-2018 on HIV (∼30% and ∼67% prevalence in males and females in 2011) and HCV prevalence (∼16% in 2017), numbers on HR interventions (5254 ever on OAT in 2018, 766-1479 accessing NSP in 2017) and ART coverage (63.1% in 2015). We evaluated the impact of existing interventions in 2019 and impact by 2030 of scaling-up the coverage of OAT (to 50% of PWID), NSP (75%, both combined termed "full HR") and ART (81% with 90% virally suppressed) from 2019, reducing sexual HIV transmission by 50%, and/or HCV-treating 10% of PWID infected with HCV annually.
resultsThe model projects HIV and HCV prevalence of 19.0% (95% credibility interval: 16.4-21.2%) and 41.0% (24.4-49.0%) in 2019, respectively. For HIV, 24.6% (13.6-32.6%) and 70.3% (59.3-77.1%) of incident infections among male and female PWID are sexually transmitted, respectively. Due to their low coverage (22.8% for OAT, 16.3% for NSP in 2019), OAT and NSP averted 20.4% (12.9-24.7%) of HIV infections and 21.7% (17.0-25.2%) of HCV infections in 2019. Existing ART (68.5% coverage by 2019) averted 48.1% (29.7-64.3%) of HIV infections in 2019. Scaling up to full HR will reduce HIV and HCV incidence by 62.6% (52.5-74.0%) and 81.4% (56.7-81.4%), respectively, over 2019-2030; scaled up ART alongside full HR will decrease HIV incidence by 66.8% (55.6-77.5%), increasing to 81.5% (73.7-87.5%) when sexual risk is also reduced. HCV-treatment alongside full HR will decrease HCV incidence by 92.4% (80.7-95.8%) by 2030.
conclusionsCombination interventions, including sexual risk reduction and HCV treatment, are needed to eliminate HCV and HIV among PWID in Tanzania.
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