Concentrated HIV subepidemics in generalized epidemic settings

Tanser, F., De Oliveira, T., Maheu-Giroux, M. and Bärnighausen, T. (2014) Concentrated HIV subepidemics in generalized epidemic settings. Current Opinion in HIV and AIDS, 9 (2). pp. 115-125. ISSN 1746-630X

Full content URL: http://doi.org/10.1097/COH.0000000000000034

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Item Type:Article
Item Status:Live Archive

Abstract

Purpose of review
A relatively neglected topic to date has been the occurrence of concentrated epidemics within generalized epidemic settings and the potential role of targeted interventions in such settings. We review recent studies in high-risk groups as well as findings relating to geographical heterogeneity and the potential for targeting ‘high-transmission zones’ in the 10 countries with highest HIV prevalence.
Recent findings
Our review of recent studies confirmed earlier findings that, even in the context of generalized epidemics, MSM have a substantially higher prevalence than the general population. Estimates of prevalence of HIV among people who inject drugs (PWID) in sub-Saharan African countries are rarely available and, when they are, often outdated. We identified recent studies of sex workers in Kenya and Uganda. In all three cases – MSM, PWID, and sex workers – HIV prevalence estimates are mostly based on convenience. Moreover, good estimates of the total size of these populations are not available. Our review of recent studies of high-risk populations defined on the basis of geography showed high levels of both new and existing infections in Kenya (slums), South Africa (peri-urban communities), and Uganda (fishing villages).
Summary
Recent empirical findings combined with evidence from phylogenetic studies and supported by mathematical models provide a clear rationale for testing the feasibility, acceptability, and effectiveness of targeted HIV prevention approaches in hyperendemic populations to supplement measures aimed at the general population.

Additional Information:cited By 67
ID Code:37486
Deposited On:07 Oct 2019 14:14

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