Population Health Sciences, Bristol Medical School, University of Bristol.
Clinical and Protecting Health Directorate, Public Health Scotland.
J Infect Dis. 2024 Jul 25;230(1):e48-e59. doi: 10.1093/infdis/jiae206.
A human immunodeficiency virus (HIV) outbreak was identified among people who inject drugs (PWID) in Glasgow in 2015, with >150 diagnoses by the end of 2019. The outbreak response involved scaling up HIV testing and improving HIV treatment initiation and retention.
We parameterized and calibrated a dynamic, deterministic model of HIV transmission among PWID in Glasgow to epidemiological data. We use this model to evaluate HIV testing and treatment interventions. We present results in terms of relative changes in HIV prevalence, incidence, and cases averted.
If the improvements in both testing and treatment had not occurred, we predict that HIV prevalence would have reached 17.8% (95% credible interval [CrI], 14.1%-22.6%) by the beginning of 2020, compared to 5.9% (95% CrI, 4.7%-7.4%) with the improvements. If the improvements had been made on detection of the outbreak in 2015, we predict that peak incidence would have been 26.2% (95% CrI, 8.8%-49.3%) lower and 62.7% (95% CrI, 43.6%-76.6%) of the outbreak cases could have been averted. The outbreak could have been avoided if the improvements had already been in place.
Our modeling suggests that the HIV testing and treatment interventions successfully brought the HIV outbreak in Glasgow under control by the beginning of 2020.
2015 年，在格拉斯哥注射吸毒人群（PWID）中发现了一起人类免疫缺陷病毒（HIV）疫情，到 2019 年底已确诊超过 150 例。疫情应对措施包括扩大 HIV 检测，并改善 HIV 治疗的开始和维持。
我们对格拉斯哥 PWID 之间的 HIV 传播进行了参数化和校准，建立了一个动态确定性模型，并利用该模型评估了 HIV 检测和治疗干预措施。我们以 HIV 流行率、发病率和预防病例数的相对变化来表示结果。
如果检测和治疗的改善没有发生，我们预测到 2020 年初 HIV 流行率将达到 17.8%（95%可信区间[CrI]，14.1%-22.6%），而有了改善则为 5.9%（95% CrI，4.7%-7.4%）。如果在 2015 年发现疫情时就进行改善，我们预测峰值发病率将降低 26.2%（95% CrI，8.8%-49.3%），并且 62.7%（95% CrI，43.6%-76.6%）的疫情病例可以得到预防。如果已经采取了这些改善措施，那么疫情就可以避免。
我们的模型表明，HIV 检测和治疗干预措施成功地在 2020 年初之前控制了格拉斯哥的 HIV 疫情。
