EMOD-HIV

EMOD HIV

EMOD HIV is a stochastic, agent-based, spatial model designed to inform policy decisions as well as investigate new interventions strategies. The within-host and transmission models allow the user to see how different interventions impact transmission. As a spatial model, EMOD HIV allows the definition of demographics, relationship dynamics, and intervention distributions in different regions as…
Individual and community-level benefits of PrEP in western Kenya and South Africa: Implications for population prioritization of PrEP provision

Background Pre-exposure prophylaxis (PrEP) is highly effective in preventing HIV and has the potential to significantly impact the HIV epidemic. Given limited resources for HIV prevention, identifying PrEP provision strategies that maximize impact is critical. Methods We used a stochastic individual-based network model to evaluate the direct (infections prevented among PrEP users) and indirect (infections…
The effect of 90-90-90 on HIV-1 incidence and mortality in eSwatini: a mathematical modelling study

Background The rapid scale-up of antiretroviral therapy (ART) towards the UNAIDS 90-90-90 goals over the last decade has sparked considerable debate as to whether universal test and treat can end the HIV-1 epidemic in sub-Saharan Africa. We aimed to develop a network transmission model, calibrated to capture age-specific and sex-specific gaps in the scale-up of…
Impact along the HIV pre-exposure prophylaxis â€œcascade of preventionâ€ in western Kenya: a mathematical modelling study

Introduction Over one hundred implementation studies of HIV pre-exposure prophylaxis (PrEP) are completed, underway or planned. We synthesized evidence from these studies to inform mathematical modelling of the prevention cascade for oral and long-acting PrEP in the setting of western Kenya, one of the world’s most heavily HIV-affected regions. Methods We incorporated steps of the…
Cost-effectiveness of point-of-care testing with task-shifting for HIV care in South Africa: a modelling study

Background The number of people on antiretroviral therapy (ART) requiring treatment monitoring in low-resource settings is rapidly increasing. Point-of-care (POC) testing for ART monitoring might alleviate burden on centralised laboratories and improve clinical outcomes, but its cost-effectiveness is unknown. Methods We used cost and effectiveness data from the STREAM trial in South Africa (February, 2017â€“October,…
The influence of mobility among high-risk populations on HIV transmission in Western Kenya

Western Kenya suffers a highly endemic and also very heterogeneous epidemic of human immunodeficiency virus (HIV). Although female sex workers (FSW) and their male clients are known to be at high risk for HIV, HIV prevalence across regions in Western Kenya is not strongly correlated with the fraction of women engaged in commercial sex. An…
Age-targeted HIV treatment and primary prevention as a â€˜ring fence' to efficiently interrupt the age patterns of transmission in generalized epidemic settings in South Africa

Background Generalized 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. Methods We modeled age-targeted or cohort-targeted outreach with HIV treatment and/or prevention using EMOD-HIV v0·8,…
Targeting HIV services to male migrant workers in southern Africa would not reverse generalized HIV epidemics

Background Migrant populations such as mine workers contributed to the spread of HIV in sub-Saharan Africa. We used a mathematical model to estimate the community-wide impact of targeting treatment and prevention to male migrants. Methods We augmented an individual-based network model, EMOD-HIV v0.8, to include an age-dependent propensity for males to migrate. Migrants were exposed…
The Cost and Cost-Effectiveness of Alternative Strategies to Expand Treatment to HIV-Positive South Africans

To study the effects of malaria-control interventions on parasite population genomics, we examined a set of 1,007 samples of the malaria parasite Plasmodium falciparum collected in ThiÃ¨s, Senegal between 2006 and 2013. The parasite samples were genotyped using a molecular barcode of 24 SNPs. About 35% of the samples grouped into subsets with identical barcodes,…
Assessment of epidemic projections using recent HIV survey data in South Africa: a validation analysis of ten mathematical models of HIV epidemiology in the antiretroviral therapy era

Background Mathematical models are widely used to simulate the effects of interventions to control HIV and to project future epidemiological trends and resource needs. We aimed to validate past model projections against data from a large household survey done in South Africa in 2012. Methods We compared ten model projections of HIV prevalence, HIV incidence,…