Abstract
Objectives: People who inject drugs (PWID) in Kenya have high HIV (range across settings:14-26%) and HCV (11-36%) prevalence. We evaluated the impact of existing and scaled-up interventions on HIV and HCV incidence among PWID in Kenya.
Design: HIV and HCV transmission model among PWID, calibrated to Nairobi and Kenya’s Coastal region.
Methods: For each setting, we projected the impact (% of HIV/HCV infections averted in 2020) of existing coverages of antiretroviral therapy (ART; 63-79%), opioid agonist therapy (OAT; 8-13%) and needle and syringe programmes (NSP; 45-61%). We then projected the impact (reduction in HIV/HCV incidence over 2021-2030), of scaling-up harm reduction (‘Full HR’: 50% OAT, 75% NSP) and/or HIV (UNAIDS 90-90-90) and HCV treatment (1000 PWID over 2021-25) and reducing sexual risk (by 25/50/75%). We estimated HCV treatment levels
needed to reduce HCV incidence by 90% by 2030.
Results: In 2020, OAT and NSP averted 46.0-50.8% (range of medians) of HIV infections and 50.0-66.1% of HCV infections, mostly due to NSP. ART only averted 12.9-39.8% of HIV infections due to sub-optimal viral suppression (28-48%). Full HR and ART could reduce HIV incidence by 51.5-64.0% and HCV incidence by 84.6-86.6% by 2030. Also halving sexual risk could reduce HIV incidence by 68.0-74.1%. Alongside Full HR, treating 2,244 PWID over 2021-2025 could reduce HCV incidence by 90% by 2030.
Conclusion: Existing interventions are having substantial impact on HIV and HCV
transmission in Kenya. However, to eliminate HIV and HCV, further scale-up is needed with reductions in sexual risk and HCV treatment
Design: HIV and HCV transmission model among PWID, calibrated to Nairobi and Kenya’s Coastal region.
Methods: For each setting, we projected the impact (% of HIV/HCV infections averted in 2020) of existing coverages of antiretroviral therapy (ART; 63-79%), opioid agonist therapy (OAT; 8-13%) and needle and syringe programmes (NSP; 45-61%). We then projected the impact (reduction in HIV/HCV incidence over 2021-2030), of scaling-up harm reduction (‘Full HR’: 50% OAT, 75% NSP) and/or HIV (UNAIDS 90-90-90) and HCV treatment (1000 PWID over 2021-25) and reducing sexual risk (by 25/50/75%). We estimated HCV treatment levels
needed to reduce HCV incidence by 90% by 2030.
Results: In 2020, OAT and NSP averted 46.0-50.8% (range of medians) of HIV infections and 50.0-66.1% of HCV infections, mostly due to NSP. ART only averted 12.9-39.8% of HIV infections due to sub-optimal viral suppression (28-48%). Full HR and ART could reduce HIV incidence by 51.5-64.0% and HCV incidence by 84.6-86.6% by 2030. Also halving sexual risk could reduce HIV incidence by 68.0-74.1%. Alongside Full HR, treating 2,244 PWID over 2021-2025 could reduce HCV incidence by 90% by 2030.
Conclusion: Existing interventions are having substantial impact on HIV and HCV
transmission in Kenya. However, to eliminate HIV and HCV, further scale-up is needed with reductions in sexual risk and HCV treatment
| Original language | English |
|---|---|
| Pages (from-to) | 2191-2201 |
| Number of pages | 11 |
| Journal | AIDS |
| Volume | 36 |
| Issue number | 15 |
| DOIs | |
| Publication status | Published - 1 Dec 2022 |
UN SDGs
This output contributes to the following UN Sustainable Development Goals (SDGs)
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SDG 3 Good Health and Well-being
Research Groups and Themes
- GEM-B
Keywords
- hepatitis C virus
- HIV
- people who inject drugs
- mathematical modelling
- Kenya
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HPC (High Performance Computing) and HTC (High Throughput Computing) Facilities
Alam, S. R. (Manager), Williams, D. A. G. (Manager), Eccleston, P. E. (Manager) & Greene, D. (Manager)
Facility/equipment: Facility
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