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Modeling HIV transmission among persons who inject drugs (PWID) at the “End of the HIV Epidemic” and during the COVID-19 pandemic
BACKGROUND: We explore injecting risk and HIV incidence among PWID in New York City (NYC), from 2012 to 2019, when incidence was extremely low, <0.1/100 person-years at risk, and during disruption of prevention services due to the COVID-19 pandemic. METHODS: We developed an Agent-Based model (ABM...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier B.V.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9278993/ https://www.ncbi.nlm.nih.gov/pubmed/35926301 http://dx.doi.org/10.1016/j.drugalcdep.2022.109573 |
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author | Jarlais, Don Des Bobashev, Georgiy Feelemyer, Jonathan McKnight, Courtney |
author_facet | Jarlais, Don Des Bobashev, Georgiy Feelemyer, Jonathan McKnight, Courtney |
author_sort | Jarlais, Don Des |
collection | PubMed |
description | BACKGROUND: We explore injecting risk and HIV incidence among PWID in New York City (NYC), from 2012 to 2019, when incidence was extremely low, <0.1/100 person-years at risk, and during disruption of prevention services due to the COVID-19 pandemic. METHODS: We developed an Agent-Based model (ABM) to simulate sharing injecting equipment and measure HIV incidence in NYC. The model was adapted from a previous ABM model developed to compare HIV transmission with “high” versus “low” dead space syringes. Data for applying the model to NYC during the period of very low HIV incidence was taken from the “Risk Factors” study, a long-running study of participants entering substance use treatment in NYC. Injecting risk behavior had not been eliminated in this population, with approximately 15 % reported recent syringe sharing. Data for possible transmission during COVID-19 disruption was taken from previous HIV outbreaks and early studies of the pandemic in NYC. RESULTS: The modeled incidence rates fell within the 95 % confidence bounds of all of the empirically observed incidence rates, without any additional calibration of the model. Potential COVID-19 disruptions increased the probability of an outbreak from 0.03 to 0.25. CONCLUSIONS: The primary factors in the very low HIV incidence were the extremely small numbers of PWID likely to transmit HIV and that most sharing occurs within small, relatively stable, mostly seroconcordant groups. Containing an HIV outbreak among PWID during a continuing pandemic would be quite difficult. Pre-pandemic levels of HIV prevention services should be restored as quickly as feasible. |
format | Online Article Text |
id | pubmed-9278993 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Elsevier B.V. |
record_format | MEDLINE/PubMed |
spelling | pubmed-92789932022-07-14 Modeling HIV transmission among persons who inject drugs (PWID) at the “End of the HIV Epidemic” and during the COVID-19 pandemic Jarlais, Don Des Bobashev, Georgiy Feelemyer, Jonathan McKnight, Courtney Drug Alcohol Depend Article BACKGROUND: We explore injecting risk and HIV incidence among PWID in New York City (NYC), from 2012 to 2019, when incidence was extremely low, <0.1/100 person-years at risk, and during disruption of prevention services due to the COVID-19 pandemic. METHODS: We developed an Agent-Based model (ABM) to simulate sharing injecting equipment and measure HIV incidence in NYC. The model was adapted from a previous ABM model developed to compare HIV transmission with “high” versus “low” dead space syringes. Data for applying the model to NYC during the period of very low HIV incidence was taken from the “Risk Factors” study, a long-running study of participants entering substance use treatment in NYC. Injecting risk behavior had not been eliminated in this population, with approximately 15 % reported recent syringe sharing. Data for possible transmission during COVID-19 disruption was taken from previous HIV outbreaks and early studies of the pandemic in NYC. RESULTS: The modeled incidence rates fell within the 95 % confidence bounds of all of the empirically observed incidence rates, without any additional calibration of the model. Potential COVID-19 disruptions increased the probability of an outbreak from 0.03 to 0.25. CONCLUSIONS: The primary factors in the very low HIV incidence were the extremely small numbers of PWID likely to transmit HIV and that most sharing occurs within small, relatively stable, mostly seroconcordant groups. Containing an HIV outbreak among PWID during a continuing pandemic would be quite difficult. Pre-pandemic levels of HIV prevention services should be restored as quickly as feasible. Elsevier B.V. 2022-09-01 2022-07-14 /pmc/articles/PMC9278993/ /pubmed/35926301 http://dx.doi.org/10.1016/j.drugalcdep.2022.109573 Text en © 2022 Elsevier B.V. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
spellingShingle | Article Jarlais, Don Des Bobashev, Georgiy Feelemyer, Jonathan McKnight, Courtney Modeling HIV transmission among persons who inject drugs (PWID) at the “End of the HIV Epidemic” and during the COVID-19 pandemic |
title | Modeling HIV transmission among persons who inject drugs (PWID) at the “End of the HIV Epidemic” and during the COVID-19 pandemic |
title_full | Modeling HIV transmission among persons who inject drugs (PWID) at the “End of the HIV Epidemic” and during the COVID-19 pandemic |
title_fullStr | Modeling HIV transmission among persons who inject drugs (PWID) at the “End of the HIV Epidemic” and during the COVID-19 pandemic |
title_full_unstemmed | Modeling HIV transmission among persons who inject drugs (PWID) at the “End of the HIV Epidemic” and during the COVID-19 pandemic |
title_short | Modeling HIV transmission among persons who inject drugs (PWID) at the “End of the HIV Epidemic” and during the COVID-19 pandemic |
title_sort | modeling hiv transmission among persons who inject drugs (pwid) at the “end of the hiv epidemic” and during the covid-19 pandemic |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9278993/ https://www.ncbi.nlm.nih.gov/pubmed/35926301 http://dx.doi.org/10.1016/j.drugalcdep.2022.109573 |
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