O19.3 Partner services for gonorrhea can decrease new HIV among MSM in king county, washington: a mathematical modeling study. (14th July 2019)

• Record Type: Journal Article
• Authors: Liu, Gui; Broshkevitch, Cara; Katz, David; Silverman, Rachel; Golden, Matthew; Barnabas, Ruanne
• Is Part Of: Sexually transmitted infections. Volume 95(2019)Supplement 1
• Page Start: A83
• Page End: A83
• Publication Date: 2019-07-14
• Subjects: gonorrhea -- HIV -- gay bisexual and other men who have sex with men; Sexually transmitted diseases -- Periodicals; HIV infections -- Periodicals; 616.951005
• DOI: 10.1136/sextrans-2019-sti.212
• Languages: English
• ISSNs: 1368-4973

Abstract

Abstract : Background: Partner services (PS) for bacterial STIs has potential to increase STI treatment among infected sex partners and HIV testing among people diagnosed with STIs and their partners. The population-level impact of PS on gonorrhea and HIV incidence has not been estimated. Methods: Calibrated to King County's MSM population, our compartmental gonorrhea-HIV coinfection model captures sexual mixing, gonorrhea and HIV transmission, and scale-up of antiretroviral therapy (ART), pre-exposure prophylaxis (PrEP), and routine STI screening. We assessed incremental impact of PS over 5 and 20 years, and compared gonorrhea and HIV incidence and prevalence without PS, with PS, and with PS that integrates promotion of HIV testing (PS+HIV). In the absence of PS, we assumed that 10%, 10%, and 95% of rectal, pharyngeal, and urethral gonorrhea were treated and 63% of MSM receiving gonorrhea treatment also received HIV testing. With PS, 40% of treated cases received PS, increasing the proportion of partners treated for gonorrhea and tested for HIV by 4%, 4%, and 38% at each site. PS+HIV increased the proportion of gonorrhea-infected MSM tested for HIV to 83%. Results: After 5 and 20 years, PS modestly changed rectal, pharyngeal, and urethral gonorrhea incidence and prevalence (<7%). After 5 years, HIV prevalence decreased 0.1% with PS and 0.5% with PS+HIV. HIV incidence decreased 6.0% (from 187.1 to 176.0 per 100, 000 persons) with PS and 14.7% (187.1 to 159.6/100, 000) with PS+HIV. After 20 years, HIV prevalence decreased 3.2% with PS and 5.6% with PS+HIV. PS reduced incidence 23.3% (75.2 to 57.7/100, 000) and PS+HIV 37.7% (75.2 to 46.9/100, 000). Conclusion: Moderate gonorrhea PS coverage had modest impact on gonorrhea, given high rates of STI testing and treatment in King County. However, long-term PS+HIV increased HIV testing opportunities and substantially reduced HIV incidence. PS+HIV is a potential approach for prioritizing HIV testing in high ART and PrEP coverage settings. Disclosure: No significant relationships.