Elimination of HIV transmission in Japanese MSM with combination interventions

BACKGROUND: Japan has a concentrated HIV epidemic, with the majority of transmission among men who have sex with men (MSM). This study aimed to explore the effect of behavioral and biomedical interventions on the HIV epidemic and forecast the time required to eliminate HIV transmission among Japanese MSM. METHODS: A deterministic compartmental model was built to estimate and forecast the HIV epidemic among Japanese MSM from 2010 to 2050. Elimination of HIV transmission among MSM was defined as incidence less than 1/1000 person-years. The time required for eliminating HIV transmission under different scenarios was calculated. FINDINGS: Under the current policies, HIV transmission cannot be eliminated by 2050. Both behavioral and biomedical interventions can achieve elimination of HIV among MSM by 2050 with annual number of sexual partners among high-risk MSM less than 9, or with condom use rate above 65%, or with testing and treatment rate above 80%, or with more than 10% PrEP coverage rate. Under comprehensive interventions, HIV elimination will be achieved in 2032, 2025 and 2024 using weak, moderate and strong intervention combinations, respectively. INTERPRETATION: Both behavioural and biomedical interventions can achieve elimination of HIV among MSM by 2050, but comprehensive interventions can accelerate the realization of this goal with higher feasibility. FUNDING: This study was funded by a Health and Labor Sciences Research Grant (Research on HIV/AIDS) from The Ministry of Health Labour and Welfare (21HB0701) and National Natural Science Foundation of China (No. 81773543 and 81973150), and the KC Wong Education Foundation.