Researchers at the Brown University School of Public Health have just published the results of their modelling study that looked at impacts different intervention strategies can have on the transmission of human immunodeficiency virus (HIV) from formerly incarcerated African-American men to African-American women. African-Americans are disproportionately affected by HIV and incarceration and related harms. The study was published in PLOS One and was led by Ms. Joëlla Adams, a PhD candidate in epidemiology at the School of Public Health. The study was supervised by Dr. Brandon Marshall, an associate professor of epidemiology at the school.
Using the TITAN model, they simulated the impact three different interventions would have on HIV transmission within a sexual and injection drug network consisting of African-Americans in Philadelphia. The first intervention consisted of a 90-90-90 strategy; in which HIV testing upon entry into a correctional facility, scaling up ART coverage and the proportion of people on Antiretroviral Therapy (ART) reaching optimal adherence covers 90 percent of the affected population. The other two interventions tested were a behavioral intervention designed to reduce sexual risk behaviors post release and an intervention that combined elements of the 90-90-90 and behavioral interventions.
The model projected 2,836 HIV transmissions to women over a span of twenty years. The 90-90-90 intervention reduced transmission to women by 29 percent, the behavioral intervention reduced transmission by 23 percent, while a combination of both strategies reduced transmission by 37 percent. These findings suggest that prison and community-based interventions for men living with HIV following release from a correctional facility have the potential to decrease community HIV incidence.Friday Letter Submission, Publish on July 26