Estimating PMTCT's Impact on Heterosexual HIV Transmission: A Mathematical Modeling Analysis

Below:  Mean HIV incidence rate in tenth year of Option B+ with High PMTCT coverage set at 20%, 40%, 60% and 80%.

ART coverage is held constant at Current levels. On the right axis, we see the mean proportion of virally suppressed individuals (viral load < 100 counts/ml), at the end of the tenth year of intervention.

Below:  Prevalence plots to produce baseline epidemics in Uganda and South Africa

At current coverage, Options B and B+ reduced heterosexual HIV incidence by about 5% and 15%, respectively, in both countries. With current ART and high PMTCT coverage, Option B+ reduced HIV incidence by 35% in Uganda and 19% in South Africa, while Option B had smaller, but meaningful, reductions. The greatest reductions in HIV incidence were achieved with high ART and PMTCT coverage. In this scenario, all PMTCT strategies yielded similar results.

Implementation of Options B/B+ reduces adult HIV incidence, with greater effect (relative to Option A at current levels) in Uganda than South Africa. These results are likely driven by Uganda’s higher fertility rates.

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