The impact of interventions on HIV transmission among couples in sub-Saharan Africa

AbstractBackground:In areas highly endemic with HIV, discordancy is prevalent among couples affected by HIV, where a substantial proportion of infected individuals are in stable sexual relationships with non-infected individuals. Designing a package of interventions to reduce HIV incidence among discordant partnerships is critical. We assessed quantitatively the impact of four interventions (antiretroviral therapy (ART), pre-exposure prophylaxis (PrEP), condoms with and with no access to couple-based voluntary counseling and testing program (VCT), and male circumcision (MC)) on HIV incidence among a cohort of discordant couples at varying levels of efficacy, adherence, eligibility, and coverage.Methods:A mathematical model was constructed to assess the impact of interventions and was parameterized by the best available evidence from clinical trials and observational studies. Uncertainty analyses were also conducted.Results:Assuming full eligibility and coverage, ART, PrEP, condoms with (and with no) acces...