O13.2 Can the UNAIDS Modes of Transmission Model Be Improved? A Comparison of the Original and Revised Model Projections Using Data from Nigeria

Abstract

of sero-discordant partnerships and 'transactional sex' groups (a relatively large subset of the population, often ignored in modelling analysis) in the model, which are classified as 'high-risk'.The UNAIDS MoT remains an accessible and potentially useful model that can help inform intervention priorities. However, our findings strongly suggest that the current model may produce misleading findings, especially in more concentrated HIV epidemic settings. Results from this study indicate the need for UNAIDS to conduct a formal review of the MoT, and for further revisions to be made.

What Really Is a Concentrated HIV Epidemic and What Does It Mean for West and Central Africa? Insights From Mathematical Modeling

“…[8][9][10][11] Studies suggest that the traditional descriptive classification system does not reflect the underlying transmission dynamics of the epidemic, especially in higher prevalence settings. The traditional classification of epidemics and output from the UNAIDS Modes of Transmission model 8,10,15 may have been misinterpreted and thus underestimated the role of SW on overall HIV transmission in SSA and potentially devalued the importance of focusing HIV prevention on FSWs and their clients. 3,14 A key question relevant for HIV programming in sub-Saharan Africa (SSA) is the extent to which unprotected SW, and unprotected sex or needle exchange among other KPs, contributes to the HIV epidemic.…”

Distinguishing sources of HIV transmission from the distribution of newly acquired HIV infections: why is it important for HIV prevention planning?

“…Precise labelling and reporting may avoid translation of MOT predictions into less effective HIV prevention policies 16. While recommendations exist on how to perform the MOT for prevention planning (minimum data requirements, sensitivity analysis, more representative sexual structures),13 16 27 there are no existing guidelines on reporting standards or how to translate MOT results into HIV prevention policies 13. Second, appropriate (and validated) tools for estimating and identifying different sources of HIV transmission (in the short term and long term) are needed.…”

Progress Toward Strengthening National Blood Transfusion Services — 14 Countries, 2011–2014

“…Second, variation in assays used for HIV screening, laboratory capacity, and testing proficiency among the countries might result in an over-or under-estimation of the HIV prevalence in collected units, which cannot be quantified. Finally, estimations of transfusion-associated HIV infections might underestimate the proportion of countries' overall annual HIV incidence attributable to unsafe blood, mainly because current incidence models do not account for test quality or rates of false negativity (9). Stronger donor selection criteria and improved screening technologies have reduced the number of HIV-positive donors being screened for donation and improved detection of HIV infections among donors, respectively (10).…”