Table 2.
Changes in HIV and Combined Gonorrhea & Chlamydia Incidence Following an 18-Month Period of Reduced HIV/STI Prevention or Treatment Service Utilization, with no Associated Changes in Behavior
| HIV | Combined STI | |||||
|---|---|---|---|---|---|---|
| Scenario | Incidence RateA | Cumul. IncidenceB | Population ImpactC | Incidence RateA | Cumul. IncidenceB | Population ImpactC |
| (95% SI) | (95% SI) | (95% SI) | (95% SI) | (95% SI) | in Thousands (95% SI) | |
| Base Scenario | ||||||
| No Changes | 1.23 (0.56, 2.05) | 62.3 (54.5, 70.7) | – | 19.39 (8.89, 31.70) | 960.4 (477.0, 1461.6) | – |
| Reduction in All Services | ||||||
| 25% | 1.56 (0.78, 2.44) | 68.7 (60.4, 78.0) | 558 (527, 590) | 35.52 (17.93, 52.41) | 1481.5 (786.4, 2081.4) | 52.0 (49.5, 54.5) |
| 50% | 1.90 (1.01, 3.02) | 76.9 (67.0, 86.5) | 1272 (1237, 1306) | 48.83 (27.53, 71.19) | 1862.1 (1114.8, 2636.8) | 92.3 (89.7, 94.9) |
| 90% | 3.26 (2.02, 4.63) | 105.6 (94.7, 118.3) | 3785 (3748, 3822) | 64.23 (38.05, 90.76) | 2261.8 (1475.7, 3045.5) | 132.7 (130.1, 135.3) |
| Reduction in PrEP Initiation | ||||||
| 25% | 1.24 (0.67, 2.14) | 63.2 (55.3, 71.6) | 63 (32, 95) | 18.47 (8.73, 31.62) | 943.7 (507.9, 1502.9) | −1.0 (−3.3, 1.5) |
| 50% | 1.33 (0.56, 2.13) | 63.9 (55.9, 72.0) | 131 (101, 165) | 18.50 (9.23, 31.68) | 936.4 (489.0, 1469.6) | −1.5 (−3.7, 0.7) |
| 90% | 1.35 (0.67, 2.25) | 65.2 (57.5, 74.4) | 261 (228, 290) | 19.50 (8.98, 32.18) | 991.6 (515.9, 1487.5) | 2.3 (0.1, 4.6) |
| Reduction in HIV Screening | ||||||
| 25% | 1.24 (0.56, 2.13) | 63.2 (54.9, 71.4) | 78 (47, 109) | 18.61 (8.98, 31.28) | 946.1 (485.3, 1462.1) | −2.2 (−4.4, 0.0) |
| 50% | 1.33 (0.56, 2.14) | 64.3 (56.2, 73.2) | 176 (144, 209) | 18.58 (8.86, 30.76) | 927.0 (496.8, 1476.8) | −1.4 (−3.5, 0.7) |
| 90% | 1.45 (0.67, 2.35) | 66.3 (58.0, 75.9) | 350 (319, 384) | 18.79 (9.40, 28.83) | 951.0 (495.8, 1424.5) | −0.6 (−2.6, 1.6) |
| Reduction in ART Retention | ||||||
| 25% | 1.24 (0.56, 2.24) | 64.0 (56.9, 72.7) | 157 (124, 189) | 18.71 (8.72, 30.16) | 943.7 (475.9, 1425.8) | −1.5 (−3.4, 0.6) |
| 50% | 1.45 (0.67, 2.48) | 67.8 (60.0, 76.1) | 469 (437, 498) | 18.51 (8.77, 29.76) | 943.0 (451.9, 1430.1) | −1.7 (−4.0, 0.6) |
| 90% | 2.26 (1.24, 3.30) | 89.0 (79.0, 97.7) | 2324 (2291, 2357) | 18.21 (9.20, 29.63) | 932.0 (508.5, 1404.8) | −2.4 (−4.5, −0.2) |
| Reduction in NG/CT Treatment | ||||||
| 25% | 1.24 (0.66, 2.26) | 64.5 (56.2, 73.2) | 184 (155, 217) | 35.31 (17.10, 54.45) | 1459.3 (768.0, 2127.0) | 51.2 (48.5, 54.0) |
| 50% | 1.44 (0.67, 2.35) | 66.3 (57.7, 75.9) | 346 (311, 377) | 49.38 (27.71, 71.72) | 1851.2 (1172.2, 2568.7) | 92.6 (89.9, 95.3) |
| 90% | 1.47 (0.77, 2.47) | 68.7 (60.6, 78.0) | 569 (536, 603) | 66.62 (41.00, 90.51) | 2310.7 (1562.6, 3010.2) | 137.9 (134.8, 140.9) |
A
Standardized rate per 100 person-years at risk at 2.5 years
B
Standardized cumulative incidence over 5 years per 1000 susceptible MSM
C
Difference, compared to base scenario, in 5-year cumulative incidence for total susceptible population of MSM in Atlanta