Reitsema Maarten, Wallinga Jacco, van Benthem Birgit H B, Op de Coul Eline L M, Van Sighem Ard, Schim van der Loeff Maarten, Xiridou Maria
Department of Epidemiology and Surveillance, National Institute for Public Health and the Environment, Bilthoven, Netherlands
Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, Zuid-Holland, Netherlands.
Sex Transm Infect. 2025 May 19;101(4):236-241. doi: 10.1136/sextrans-2023-055772.
Men who have sex with men (MSM) are disproportionally affected by HIV in the Netherlands. Partner notification (PN) is an important element in controlling the transmission of sexually transmitted infections (STIs) and HIV. We investigated the effects of improving PN on the transmission of HIV and (NG) among MSM in the Netherlands. We developed an agent-based model that describes the transmission of HIV and NG among MSM. In the baseline scenario, 14.3% and 29.8% of casual and steady partners of the index case get notified and tested for HIV/STI after 3 weeks (percentage notified and tested (PNT)). We examined the following scenarios: (1) increase PNT to 41% for both partner types; (2) decrease the time between the index and the partners tested to 1 week and (3) combine scenarios 1 and 2. Effects are expressed as cumulative change from the baseline simulation over 15 years. Increasing PNT could lead to a decrease in gonorrhoea cases of 45% (IQR 39.9% to 49.9%), with an increase in the number of HIV/STI tests of 4.4% (IQR 1.6% to 7.3%), but no change in HIV infections (-5.4%; IQR -21% to 7.9%). Decreasing the time between tests could lead to a change in new NG infections of -14.2% (IQR -17.2% to -10%), no change in HIV infections (8.2%; IQR -1.3% to 20%) or in the number of HIV/STI tests performed (-0.4%; IQR -1.5 to 0.6%). Scenario 3 led to a change in NG infections of -56.8% (IQR -63.8% to -47.4%), no change in HIV infections (11.5%; IQR -11.1% to 33.9%) or in the number of HIV/STI tests (-0.5%; IQR: -4.9% to 4.3%). Increasing the percentage of sexual partners notified and tested for HIV/STI may have only a small effect on HIV but could reduce the number of new NG infections substantially. However, it could lead to an increase in the number of HIV/STI tests performed.
在荷兰，男男性行为者（MSM）受艾滋病毒影响的比例过高。性伴通知（PN）是控制性传播感染（STIs）和艾滋病毒传播的重要环节。我们调查了改善性伴通知对荷兰男男性行为者中艾滋病毒和淋病（NG）传播的影响。我们开发了一个基于主体的模型，用于描述男男性行为者中艾滋病毒和淋病的传播情况。在基线情景中，索引病例的14.3%和29.8%的偶然和固定性伴在3周后得到通知并接受艾滋病毒/性传播感染检测（通知并检测百分比（PNT））。我们研究了以下情景：（1）将两种性伴类型的PNT提高到41%；（2）将索引病例与接受检测的性伴之间的时间缩短至1周；以及（3）结合情景1和情景2。结果以15年基线模拟的累积变化表示。提高PNT可导致淋病病例减少45%（四分位距39.9%至49.9%），艾滋病毒/性传播感染检测次数增加4.4%（四分位距1.6%至7.3%），但艾滋病毒感染率无变化（-5.4%；四分位距-21%至7.9%）。缩短检测间隔时间可使新的淋病感染率变化-14.2%（四分位距-17.2%至-10%），艾滋病毒感染率（8.2%；四分位距-1.3%至20%）或艾滋病毒/性传播感染检测次数（-0.4%；四分位距-1.5%至0.6%）无变化。情景3导致淋病感染率变化-56.8%（四分位距-63.8%至-47.4%），艾滋病毒感染率（11.5%；四分位距-11.1%至33.9%）或艾滋病毒/性传播感染检测次数（-0.5%；四分位距：-4.9%至4.3%）无变化。提高接受艾滋病毒/性传播感染通知和检测的性伴比例可能对艾滋病毒只有微小影响，但可大幅减少新的淋病感染病例数。然而，这可能导致艾滋病毒/性传播感染检测次数增加。
