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
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,...
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| Veröffentlicht in: | Journal of acquired immune deficiency syndromes (1999) 2007-09, Vol.46 (1), p.78-90 |
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| container_title | Journal of acquired immune deficiency syndromes (1999) |
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| creator | Andersson, Kyeen M Owens, Douglas K Vardas, Eftyhia Gray, Glenda E McIntyre, James A Paltiel, A David |
| description | 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 postvaccination 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 |
| doi_str_mv | 10.1097/QAI.0b013e31812506fd |
| format | Article |
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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 postvaccination 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.</description><identifier>ISSN: 1525-4135</identifier><identifier>EISSN: 1944-7884</identifier><identifier>DOI: 10.1097/QAI.0b013e31812506fd</identifier><identifier>PMID: 17589368</identifier><identifier>CODEN: JDSRET</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins, Inc</publisher><subject>AIDS Vaccines - immunology ; AIDS/HIV ; Behavior ; Biological and medical sciences ; Computer Simulation ; Condoms ; Condoms - utilization ; Female ; Fundamental and applied biological sciences. Psychology ; HIV ; HIV Infections - economics ; HIV Infections - epidemiology ; HIV Infections - prevention & control ; HIV Infections - psychology ; Human immunodeficiency virus ; Human viral diseases ; Humans ; Immunization ; Infectious diseases ; Male ; Mathematical models ; Medical sciences ; Microbiology ; Miscellaneous ; Models, Biological ; Risk Factors ; Sensitivity and Specificity ; Sex Factors ; Socioeconomic Factors ; South Africa - epidemiology ; Time Factors ; Unsafe Sex - statistics & numerical data ; Vaccines, antisera, therapeutical immunoglobulins and monoclonal antibodies ; Viral diseases ; Viral diseases of the lymphoid tissue and the blood. Aids ; Virology</subject><ispartof>Journal of acquired immune deficiency syndromes (1999), 2007-09, Vol.46 (1), p.78-90</ispartof><rights>2007 Lippincott Williams & Wilkins, Inc.</rights><rights>2007 INIST-CNRS</rights><rights>Copyright Lippincott Williams & Wilkins Sep 1, 2007</rights><rights>Copyright © 2007 by Lippincott Williams & Wilkins 2007</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c4422-1eadc621127c95b31f5d97a7e64a3e9a82e9c530ed141592ebd875bb8adc9a53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttp://ovidsp.ovid.com/ovidweb.cgi?T=JS&NEWS=n&CSC=Y&PAGE=fulltext&D=ovft&AN=00126334-200709010-00012$$EHTML$$P50$$Gwolterskluwer$$H</linktohtml><link.rule.ids>230,314,776,780,881,4595,27901,27902,65206</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=19040298$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17589368$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Andersson, Kyeen M</creatorcontrib><creatorcontrib>Owens, Douglas K</creatorcontrib><creatorcontrib>Vardas, Eftyhia</creatorcontrib><creatorcontrib>Gray, Glenda E</creatorcontrib><creatorcontrib>McIntyre, James A</creatorcontrib><creatorcontrib>Paltiel, A David</creatorcontrib><title>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</title><title>Journal of acquired immune deficiency syndromes (1999)</title><addtitle>J Acquir Immune Defic Syndr</addtitle><description>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 postvaccination 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.</description><subject>AIDS Vaccines - immunology</subject><subject>AIDS/HIV</subject><subject>Behavior</subject><subject>Biological and medical sciences</subject><subject>Computer Simulation</subject><subject>Condoms</subject><subject>Condoms - utilization</subject><subject>Female</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>HIV</subject><subject>HIV Infections - economics</subject><subject>HIV Infections - epidemiology</subject><subject>HIV Infections - prevention & control</subject><subject>HIV Infections - psychology</subject><subject>Human immunodeficiency virus</subject><subject>Human viral diseases</subject><subject>Humans</subject><subject>Immunization</subject><subject>Infectious diseases</subject><subject>Male</subject><subject>Mathematical models</subject><subject>Medical sciences</subject><subject>Microbiology</subject><subject>Miscellaneous</subject><subject>Models, Biological</subject><subject>Risk Factors</subject><subject>Sensitivity and Specificity</subject><subject>Sex Factors</subject><subject>Socioeconomic Factors</subject><subject>South Africa - epidemiology</subject><subject>Time Factors</subject><subject>Unsafe Sex - statistics & numerical data</subject><subject>Vaccines, antisera, therapeutical immunoglobulins and monoclonal antibodies</subject><subject>Viral diseases</subject><subject>Viral diseases of the lymphoid tissue and the blood. Aids</subject><subject>Virology</subject><issn>1525-4135</issn><issn>1944-7884</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkstu1DAUhiMEoqXwBghZSLBL8TWJWSANo4GOVMSlVbeW45w0bh17sJNe3o2Hw21HFLphZcv-zn98fv9F8ZLgfYJl_e77Yr2PW0wYMNIQKnDVd4-KXSI5L-um4Y_zXlBRcsLETvEspTOMScW5fFrskFo0klXNbvHrW4TOmsn6UzQNgNbjRpsJhR5p9E3HyWrnrtGq7yEzF4AO1ifoRBtjPSDtO3Q0twl-zuAn9MOmc_QRBn1hQ0TLQftTQMHfyh7ABDEkuJq1u9VYbWwHozXIenQYLstbsS-26xyUa2_CCGgZZj9FC-k9WqCjME8DWvTRGu3R6kqPGwfPiye9dglebNe94vjT6nh5UB5-_bxeLg5LwzmlJQHdmYoSQmsjRctILzpZ6xoqrhlI3VCQRjAMHeFESApt19SibZtcJrVge8WHO9nN3I7QmTxs1E5toh11vFZBW_XvjbeDOg0XiokaU15ngbdbgRiyV2lSo00GnNMewpxU1XDMRCX_CxIpGtrQKoOvH4BnYY4-m6AoYxUXuGYZ4neQydanCP2fJxOsbjKkcobUwwzlsld_j3tftA1NBt5sAZ2Mdn3U3th0z0nMMZXNff_L4PL3p3M3X0JUA2g3DSqnMQ_CeEkxrrHEBJf45oz9BsZu4eI</recordid><startdate>20070901</startdate><enddate>20070901</enddate><creator>Andersson, Kyeen M</creator><creator>Owens, Douglas K</creator><creator>Vardas, Eftyhia</creator><creator>Gray, Glenda E</creator><creator>McIntyre, James A</creator><creator>Paltiel, A David</creator><general>Lippincott Williams & Wilkins, Inc</general><general>Lippincott Williams & Wilkins</general><general>Lippincott Williams & Wilkins Ovid Technologies</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T2</scope><scope>7T5</scope><scope>7TK</scope><scope>7U7</scope><scope>7U9</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>7U1</scope><scope>7U2</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20070901</creationdate><title>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</title><author>Andersson, Kyeen M ; Owens, Douglas K ; Vardas, Eftyhia ; Gray, Glenda E ; McIntyre, James A ; Paltiel, A David</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4422-1eadc621127c95b31f5d97a7e64a3e9a82e9c530ed141592ebd875bb8adc9a53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>AIDS Vaccines - immunology</topic><topic>AIDS/HIV</topic><topic>Behavior</topic><topic>Biological and medical sciences</topic><topic>Computer Simulation</topic><topic>Condoms</topic><topic>Condoms - utilization</topic><topic>Female</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>HIV</topic><topic>HIV Infections - economics</topic><topic>HIV Infections - epidemiology</topic><topic>HIV Infections - prevention & control</topic><topic>HIV Infections - psychology</topic><topic>Human immunodeficiency virus</topic><topic>Human viral diseases</topic><topic>Humans</topic><topic>Immunization</topic><topic>Infectious diseases</topic><topic>Male</topic><topic>Mathematical models</topic><topic>Medical sciences</topic><topic>Microbiology</topic><topic>Miscellaneous</topic><topic>Models, Biological</topic><topic>Risk Factors</topic><topic>Sensitivity and Specificity</topic><topic>Sex Factors</topic><topic>Socioeconomic Factors</topic><topic>South Africa - epidemiology</topic><topic>Time Factors</topic><topic>Unsafe Sex - statistics & numerical data</topic><topic>Vaccines, antisera, therapeutical immunoglobulins and monoclonal antibodies</topic><topic>Viral diseases</topic><topic>Viral diseases of the lymphoid tissue and the blood. Aids</topic><topic>Virology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Andersson, Kyeen M</creatorcontrib><creatorcontrib>Owens, Douglas K</creatorcontrib><creatorcontrib>Vardas, Eftyhia</creatorcontrib><creatorcontrib>Gray, Glenda E</creatorcontrib><creatorcontrib>McIntyre, James A</creatorcontrib><creatorcontrib>Paltiel, A David</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Risk Abstracts</collection><collection>Safety Science and Risk</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of acquired immune deficiency syndromes (1999)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Andersson, Kyeen M</au><au>Owens, Douglas K</au><au>Vardas, Eftyhia</au><au>Gray, Glenda E</au><au>McIntyre, James A</au><au>Paltiel, A David</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>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</atitle><jtitle>Journal of acquired immune deficiency syndromes (1999)</jtitle><addtitle>J Acquir Immune Defic Syndr</addtitle><date>2007-09-01</date><risdate>2007</risdate><volume>46</volume><issue>1</issue><spage>78</spage><epage>90</epage><pages>78-90</pages><issn>1525-4135</issn><eissn>1944-7884</eissn><coden>JDSRET</coden><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 postvaccination 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.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins, Inc</pub><pmid>17589368</pmid><doi>10.1097/QAI.0b013e31812506fd</doi><tpages>13</tpages></addata></record> |
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| ispartof | Journal of acquired immune deficiency syndromes (1999), 2007-09, Vol.46 (1), p.78-90 |
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| subjects | AIDS Vaccines - immunology AIDS/HIV Behavior Biological and medical sciences Computer Simulation Condoms Condoms - utilization Female Fundamental and applied biological sciences. Psychology HIV HIV Infections - economics HIV Infections - epidemiology HIV Infections - prevention & control HIV Infections - psychology Human immunodeficiency virus Human viral diseases Humans Immunization Infectious diseases Male Mathematical models Medical sciences Microbiology Miscellaneous Models, Biological Risk Factors Sensitivity and Specificity Sex Factors Socioeconomic Factors South Africa - epidemiology Time Factors Unsafe Sex - statistics & numerical data Vaccines, antisera, therapeutical immunoglobulins and monoclonal antibodies Viral diseases Viral diseases of the lymphoid tissue and the blood. Aids Virology |
| title | 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 |
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