Proportion of new HIV infections attributable to herpes simplex 2 increases over time: simulations of the changing role of sexually transmitted infections in sub-Saharan African HIV epidemics.

摘要: Objective: To understand the changing impact of herpes simplex 2 (HSV-2) and other sexually transmitted infections (STIs) on HIV incidence over time in four sub-Saharan African cities, using simulation models. Methods: An individual-based stochastic model was fitted to demographic, behavioural epidemiological data from cross-sectional population-based surveys cities (Kisumu, Kenya; Ndola, Zambia; Yaounde, Cameroon; Cotonou, Benin) 1997. estimate proportion new attributable HSV-2 STIs time, compared with that scenarios which cofactor effect susceptibility infectivity were removed 5, 10, 15, 20 25 years into simulated epidemics. Results: The incident infection (the estimated population fraction (PAF M )) increased maturity epidemic. In different PAF 8–31% 5 epidemic, but rose 35–48% 15 after introduction HIV. contrast, chancroid decreased strongest effects five introduction, falling no after. Sensitivity analyses showed that, model, recurrent ulcers had more an than did primary ulcers, may be important for spread susceptibility, assuming has similar infectivity. overall curable (syphilis, gonorrhoea chlamydia) remained relatively constant time. Conclusions: Although appears have a limited early stages epidemics when epidemic is concentrated core groups, it increasingly large as progresses. generalised where control programmes are already place, interventions against key role prevention.