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P3.384 Estimating the Impact of Combined Prevention Interventions Targeting 15–24 Years-Old Men and Women in Nyanza, Kenya
  1. R Alsallaq1,
  2. J Buttolph1,
  3. C Cleland1,
  4. T Hallett2,
  5. A Kurth1
  1. 1College of Nursing Global, New York University, New York, NY, United States
  2. 2Imperial College, London, UK

Abstract

Background Young males (YMs) and especially young females (YFs) (age 15–24) in sub-Saharan Africa are at a higher risk of HIV infection compared to older adults. HIV testing of young individuals facilitates early identification of their ‘HIV+’ status, prompt ART initiation, and provision of male circumcision and PrEP. We hypothesise that youth-prioritised combination interventions could have substantial impact on HIV incidence among them and the wider adult population.

Methods We constructed a mathematical model that represented HIV heterosexual transmission in Nyanza, Kenya and used local data to specify cross-generational sex, risk- and age-dependent behaviours, and school attendance. We estimated the impact of leveraging HIV testing and counselling for condom use among Nyanza youth, prompt ART initiation (at CD4≤ 350 cells/mm3) for those newly-found infected, and gender-specific interventions for YMs and YFs. The former reaching 80% circumcision among ‘HIV-‘ YMs while the later reaching 40% PrEP coverage among ‘HIV-‘ YFs not attending school and halving the proportion of partnerships that YFs attending school form with 20+ years-old men.

Results We predict a reduction in HIV incidence over 10 years among youth by 38% (from 1.6%/person-years) and adults by 29% (from 1.2%/person-years), if the annual testing likelihood for youth increases to 90% with those newly-found infected increasing condom use by 30% and initiating ART promptly. The adult incidence is reduced 34% and 35% by further male and female specific interventions when applied separately. The full package with all interventions combined would decrease incidence among youth and adults by 59% and 40%, respectively, and reduce the lifetime HIV risk experienced by YFs by 24%.

Conclusion In populations where young people are at the highest risk of HIV infection, carefully prioritised, gender-specific intervention can have a substantial impact on the risk of infection, both in that group and the overall population.

  • Combination interventions against HIV
  • Mathematical modeling
  • Young women and men

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