Impact of the 90-90-90 goal and pre-exposure prophylaxis on HIV transmission and elimination in men who have sex with men in China: A mathematical modeling study / 中华流行病学杂志

ABSTRACT

Objective To establish a dynamic compartmental model to predict the impact of HIV testing and treatment and pre-exposure prophylaxis (PrEP) on the annual incidence of HIV infection in men who have sex with men (MSM) in China from 2018 to 2037.Methods A dynamic compartmental model was developed to describe the HIV epidemic in MSM in China.The model was parameterized using data from the literature available.We used MATLAB 7.0 software for data simulation and graphics rendering.We analyzed HIV transmission among MSM and estimated the impact of expanded HIV testing and treatment and PrEP on HIV elimination in MSM.Results Under the current policy,the number of new HIV infections would reach 770 000,the infection rate would reach 11.1％ and the incidence rate would reach 0.72/100 person years in MSM in the next 20 years.Under the 90％-90％-90％ goal,440 000 new infections (57.7％) would be reduced,the HIV infection rate would decline to 5.7％ and the incidence rate would decline to 0.24/100 person years in the next 20 years,but it is still unlikely to achieve the goal of HIV elimination.With 100％ PrEP compliance,the required PrEP coverage rates for achieving HIV elimination in the next 10,15 and 20 years would be 65％,32％ and 19％,respectively.Conclusion It is necessary to strengthen the comprehensive intervention in MSM,continue to expand HIV testing and treatment,and improve PrEP adherence and coverage to further control and eliminate the epidemic of HIV/AIDS in MSM.