Predicting the Impact of a Partially Effective HIV Vaccine and Subsequent Risk Behavior Change on the Heterosexual HIV Epidemic in Low- and Middle-Income Countries A South African Example
Identifieur interne : 006440 ( Main/Exploration ); précédent : 006439; suivant : 006441Predicting the Impact of a Partially Effective HIV Vaccine and Subsequent Risk Behavior Change on the Heterosexual HIV Epidemic in Low- and Middle-Income Countries A South African Example
Auteurs : Kyeen M. Andersson [États-Unis] ; Douglas K. Owens [États-Unis] ; Eftyhia Vardas [Afrique du Sud] ; Glenda E. Gray [Afrique du Sud] ; James A. Mcintyre [Afrique du Sud] ; A. David Paltiel [États-Unis]Source :
- Journal of acquired immune deficiency syndromes (1999) [ 1525-4135 ] ; 2007.
Descripteurs français
- KwdFr :
- Comportement sexuel à risque (), Facteurs de risque, Facteurs sexuels, Facteurs socioéconomiques, Facteurs temps, Femelle, Humains, Infections à VIH (), Infections à VIH (psychologie), Infections à VIH (économie), Infections à VIH (épidémiologie), Modèles biologiques, Mâle, Préservatifs masculins (utilisation), République d'Afrique du Sud (épidémiologie), Sensibilité et spécificité, Simulation numérique, Vaccins contre le SIDA (immunologie).
- MESH :
- immunologie : Vaccins contre le SIDA.
- psychologie : Infections à VIH.
- utilisation : Préservatifs masculins.
- économie : Infections à VIH.
- épidémiologie : Infections à VIH, République d'Afrique du Sud.
- Comportement sexuel à risque, Facteurs de risque, Facteurs sexuels, Facteurs socioéconomiques, Facteurs temps, Femelle, Humains, Infections à VIH, Modèles biologiques, Mâle, Sensibilité et spécificité, Simulation numérique.
- Wicri :
- geographic : Afrique du Sud.
English descriptors
- KwdEn :
- AIDS Vaccines (immunology), Computer Simulation, Condoms (utilization), Female, HIV Infections (economics), HIV Infections (epidemiology), HIV Infections (prevention & control), HIV Infections (psychology), Humans, Male, Models, Biological, Risk Factors, Sensitivity and Specificity, Sex Factors, Socioeconomic Factors, South Africa (epidemiology), Time Factors, Unsafe Sex (statistics & numerical data).
- MESH :
- chemical , immunology : AIDS Vaccines.
- geographic , epidemiology : South Africa.
- economics : HIV Infections.
- epidemiology : HIV Infections.
- prevention & control : HIV Infections.
- psychology : HIV Infections.
- statistics & numerical data : Unsafe Sex.
- utilization : Condoms.
- Computer Simulation, Female, Humans, Male, Models, Biological, Risk Factors, Sensitivity and Specificity, Sex Factors, Socioeconomic Factors, Time Factors.
Abstract
We developed a mathematical model to simulate the impact of various partially effective preventive HIV vaccination scenarios in a population at high risk for heterosexually transmitted HIV. We considered an adult population defined by gender (male/female), disease stage (HIV-negative, HIV-positive, AIDS, and death), and vaccination status (unvaccinated/vaccinated) in Soweto, South Africa. Input data included initial HIV prevalence of 20% (women) and 12% (men), vaccination coverage of 75%, and exclusive male negotiation of condom use. We explored how changes in vaccine efficacy and post-vaccination condom use would affect HIV prevalence and total HIV infections prevented over a 10-year period. In the base-case scenario, a 40% effective HIV vaccine would avert 61,000 infections and reduce future HIV prevalence from 20% to 13%. A 25% increase (or decrease) in condom use among vaccinated individuals would instead avert 75,000 (or only 46,000) infections and reduce the HIV prevalence to 12% (or only 15%). Furthermore, certain combinations of increased risk behavior and vaccines with <43% efficacy could worsen the epidemic. Even modestly effective HIV vaccines can confer enormous benefits in terms of HIV infections averted and decreased HIV prevalence. However, programs to reduce risk behavior may be important components of successful vaccination campaigns.
Url:
DOI: 10.1097/QAI.0b013e31812506fd
PubMed: 17589368
PubMed Central: 3570247
Affiliations:
- Afrique du Sud, États-Unis
- Californie, Connecticut, Gauteng
- Johannesbourg
- Université du Witwatersrand
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Le document en format XML
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Andersson</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Connecticut</region></placeName><wicri:cityArea>Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven</wicri:cityArea></affiliation></author><author><name sortKey="Owens, Douglas K" sort="Owens, Douglas K" uniqKey="Owens D" first="Douglas K." last="Owens">Douglas K. 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Gray</name><affiliation wicri:level="4"><nlm:aff id="A4">Perinatal HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Perinatal HIV Research Unit, University of the Witwatersrand, Johannesburg</wicri:regionArea><orgName type="university">Université du Witwatersrand</orgName><placeName><settlement type="city">Johannesbourg</settlement><region type="region" nuts="2">Gauteng</region></placeName></affiliation></author><author><name sortKey="Mcintyre, James A" sort="Mcintyre, James A" uniqKey="Mcintyre J" first="James A." last="Mcintyre">James A. Mcintyre</name><affiliation wicri:level="4"><nlm:aff id="A4">Perinatal HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Perinatal HIV Research Unit, University of the Witwatersrand, Johannesburg</wicri:regionArea><orgName type="university">Université du Witwatersrand</orgName><placeName><settlement type="city">Johannesbourg</settlement><region type="region" nuts="2">Gauteng</region></placeName></affiliation></author><author><name sortKey="Paltiel, A David" sort="Paltiel, A David" uniqKey="Paltiel A" first="A. David" last="Paltiel">A. David Paltiel</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Connecticut</region></placeName><wicri:cityArea>Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven</wicri:cityArea></affiliation></author></analytic><series><title level="j">Journal of acquired immune deficiency syndromes (1999)</title><idno type="ISSN">1525-4135</idno><idno type="eISSN">1944-7884</idno><imprint><date when="2007">2007</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>AIDS Vaccines (immunology)</term><term>Computer Simulation</term><term>Condoms (utilization)</term><term>Female</term><term>HIV Infections (economics)</term><term>HIV Infections (epidemiology)</term><term>HIV Infections (prevention & control)</term><term>HIV Infections (psychology)</term><term>Humans</term><term>Male</term><term>Models, Biological</term><term>Risk Factors</term><term>Sensitivity and Specificity</term><term>Sex Factors</term><term>Socioeconomic Factors</term><term>South Africa (epidemiology)</term><term>Time Factors</term><term>Unsafe Sex (statistics & numerical data)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Comportement sexuel à risque ()</term><term>Facteurs de risque</term><term>Facteurs sexuels</term><term>Facteurs socioéconomiques</term><term>Facteurs temps</term><term>Femelle</term><term>Humains</term><term>Infections à VIH ()</term><term>Infections à VIH (psychologie)</term><term>Infections à VIH (économie)</term><term>Infections à VIH (épidémiologie)</term><term>Modèles biologiques</term><term>Mâle</term><term>Préservatifs masculins (utilisation)</term><term>République d'Afrique du Sud (épidémiologie)</term><term>Sensibilité et spécificité</term><term>Simulation numérique</term><term>Vaccins contre le SIDA (immunologie)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="immunology" xml:lang="en"><term>AIDS Vaccines</term></keywords><keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>South Africa</term></keywords><keywords scheme="MESH" qualifier="economics" xml:lang="en"><term>HIV Infections</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>HIV Infections</term></keywords><keywords scheme="MESH" qualifier="immunologie" xml:lang="fr"><term>Vaccins contre le SIDA</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>HIV Infections</term></keywords><keywords scheme="MESH" qualifier="psychologie" xml:lang="fr"><term>Infections à VIH</term></keywords><keywords scheme="MESH" qualifier="psychology" xml:lang="en"><term>HIV Infections</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Unsafe Sex</term></keywords><keywords scheme="MESH" qualifier="utilisation" xml:lang="fr"><term>Préservatifs masculins</term></keywords><keywords scheme="MESH" qualifier="utilization" xml:lang="en"><term>Condoms</term></keywords><keywords scheme="MESH" qualifier="économie" xml:lang="fr"><term>Infections à VIH</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Infections à VIH</term><term>République d'Afrique du Sud</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Computer Simulation</term><term>Female</term><term>Humans</term><term>Male</term><term>Models, Biological</term><term>Risk Factors</term><term>Sensitivity and Specificity</term><term>Sex Factors</term><term>Socioeconomic Factors</term><term>Time Factors</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Comportement sexuel à risque</term><term>Facteurs de risque</term><term>Facteurs sexuels</term><term>Facteurs socioéconomiques</term><term>Facteurs temps</term><term>Femelle</term><term>Humains</term><term>Infections à VIH</term><term>Modèles biologiques</term><term>Mâle</term><term>Sensibilité et spécificité</term><term>Simulation numérique</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Afrique du Sud</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><title>Summary</title><p id="P1">We developed a mathematical model to simulate the impact of various partially effective preventive HIV vaccination scenarios in a population at high risk for heterosexually transmitted HIV. We considered an adult population defined by gender (male/female), disease stage (HIV-negative, HIV-positive, AIDS, and death), and vaccination status (unvaccinated/vaccinated) in Soweto, South Africa. Input data included initial HIV prevalence of 20% (women) and 12% (men), vaccination coverage of 75%, and exclusive male negotiation of condom use. We explored how changes in vaccine efficacy and post-vaccination condom use would affect HIV prevalence and total HIV infections prevented over a 10-year period. In the base-case scenario, a 40% effective HIV vaccine would avert 61,000 infections and reduce future HIV prevalence from 20% to 13%. A 25% increase (or decrease) in condom use among vaccinated individuals would instead avert 75,000 (or only 46,000) infections and reduce the HIV prevalence to 12% (or only 15%). Furthermore, certain combinations of increased risk behavior and vaccines with <43% efficacy could worsen the epidemic. Even modestly effective HIV vaccines can confer enormous benefits in terms of HIV infections averted and decreased HIV prevalence. However, programs to reduce risk behavior may be important components of successful vaccination campaigns.</p></div></front></TEI><affiliations><list><country><li>Afrique du Sud</li><li>États-Unis</li></country><region><li>Californie</li><li>Connecticut</li><li>Gauteng</li></region><settlement><li>Johannesbourg</li></settlement><orgName><li>Université du Witwatersrand</li></orgName></list><tree><country name="États-Unis"><region name="Connecticut"><name sortKey="Andersson, Kyeen M" sort="Andersson, Kyeen M" uniqKey="Andersson K" first="Kyeen M." last="Andersson">Kyeen M. Andersson</name></region><name sortKey="Owens, Douglas K" sort="Owens, Douglas K" uniqKey="Owens D" first="Douglas K." last="Owens">Douglas K. Owens</name><name sortKey="Owens, Douglas K" sort="Owens, Douglas K" uniqKey="Owens D" first="Douglas K." last="Owens">Douglas K. Owens</name><name sortKey="Paltiel, A David" sort="Paltiel, A David" uniqKey="Paltiel A" first="A. David" last="Paltiel">A. David Paltiel</name></country><country name="Afrique du Sud"><region name="Gauteng"><name sortKey="Vardas, Eftyhia" sort="Vardas, Eftyhia" uniqKey="Vardas E" first="Eftyhia" last="Vardas">Eftyhia Vardas</name></region><name sortKey="Gray, Glenda E" sort="Gray, Glenda E" uniqKey="Gray G" first="Glenda E." last="Gray">Glenda E. Gray</name><name sortKey="Mcintyre, James A" sort="Mcintyre, James A" uniqKey="Mcintyre J" first="James A." last="Mcintyre">James A. Mcintyre</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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