Journal Article

Modeling of the HIV epidemic and continuum of care in French Guiana

Vantilcke, Vincent, Nacher, Mathieu, Huber, Florence, Djossou, Félix, Couppié, Pierre, Adriouch, Leila, Adenis, Antoine, Elenga, Narcisse

2018

Overview

In order to compute the continuum of care for French Guiana, it is necessary to estimate the total number of persons living with HIV. The main objective was to determine how many persons were infected with HIV and how many were unaware of it. We used 2 different models to calculate the total number of persons infected with HIV: Spectrum's AIM module using CSAVR to compute incidence from case registration and vital statistics; and the ECDC model from the French Guiana HIV cohort data. The present results show that both models led to similar results regarding the incident number of cases (i.e. for 2016 174 versus 161) and the total HIV population (in 2016 3206 versus 3539) respectively. The ECDC modeling tool showed that the proportion of undiagnosed HIV infections declined from 50% in 1990 to 15% in 2015. This amounted to a stable or slightly increasing total number of undiagnosed patients of 520. The estimations of the total HIV population by both models show that the HIV population is still growing. The incidence rate declined in 2000 and the decline of the number of newly acquired HIV infections, after a decline after 2003 is offset by population growth. The proportion of undiagnosed infections has declined to 15% but the number of undiagnosed infections remains stable. The HIV cascade shows that despite good results for treatment in care, reaching the 90*90*90 UNAIDS target may be difficult because a significant proportion of patients are lost to follow-up.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Acquired immune deficiency syndrome / Adult / AIDS / Analysis / Antiretroviral drugs / Biology and Life Sciences / Care and treatment / Continuity of Patient Care - standards / Diagnosis / Epidemics / Epidemiology / Female / French Guiana - epidemiology / Health aspects / Health care access / Health surveillance / HIV / HIV - isolation & purification / HIV infections / HIV Infections - epidemiology / HIV Infections - virology / HIV patients / Human immunodeficiency virus / Humans / Incidence / Infections / Life Sciences / Male / Medical diagnosis / Medical tests / Medicine and health sciences / Modelling / Models, Statistical / Mortality / Patient care / Patients / People and Places / Population growth / Public health / Registration / Reporting requirements / Risk Factors / Santé publique et épidémiologie / Vital statistics