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Modeling Combinatio...
Modeling Combination Interventions to Prevent Human Immunodeficiency Virus in Adolescent Girls and Young Women in South Africa (HIV Prevention Trials Network 068)
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- Stoner, Marie C.D. (författare)
- Carolina Population Center, University of North Carolina, Chapel Hill, NC, United States; Women's Global Health Imperative, RTI International, CA, San Francisco, United States
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- Westreich, Daniel (författare)
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
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- Ahern, Jennifer (författare)
- School of Public Health, Division of Epidemiology and Biostatistics, University of California, CA, Berkeley, United States
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- Edwards, Jessie (författare)
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
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- Gómez-Olivé, F. Xavier (författare)
- Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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- Tollman, Stephen M. (författare)
- Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; INDEPTH Network, Accra, Ghana
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- Lippman, Sheri (författare)
- Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Department of Medicine, University of California, CA, San Francisco, United States
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- Kahn, Kathleen (författare)
- Umeå universitet,Institutionen för epidemiologi och global hälsa,Institutionen för folkhälsa och klinisk medicin,Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; INDEPTH Network, Accra, Ghana
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- Pettifor, Audrey (författare)
- Carolina Population Center, University of North Carolina, Chapel Hill, NC, United States; Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States; Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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(creator_code:org_t)
- 2020-12-16
- 2021
- Engelska.
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Ingår i: Clinical Infectious Diseases. - : Oxford University Press. - 1058-4838 .- 1537-6591. ; 73:7, s. e1911-e1918
- Relaterad länk:
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https://www.ncbi.nlm...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
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- BACKGROUND: Combination interventions may be an effective way to prevent human immunodeficiency virus (HIV) in adolescent girls and young women. However, current studies are not designed to understand which specific interventions and combinations will be most effective. We estimate the possible impacts of interventions on a combination of factors associated with HIV.METHODS: We used the g-formula to model interventions on combinations of HIV risk factors to identify those that would prevent the most incident HIV infections, including low school attendance, intimate partner violence, depression, transactional sex, and age-disparate partnerships. We used data from the HIV Prevention Trials Network (HPTN) 068 study in rural South Africa from 2011 to 2017. We estimated HIV incidence under a potential intervention that reduced each risk factor and compared this to HIV incidence under the current distribution of these risk factors.RESULTS: Although many factors had strong associations with HIV, potential intervention estimates did not always suggest large reductions in HIV incidence because the prevalence of risk factors was low. When modeling combination effects, an intervention to increase schooling, decrease depression, and decease transactional sex showed the largest reduction in incident infection (risk difference, -1.4%; 95% confidence interval [CI], -2.7% to -.2%), but an intervention on only transactional sex and depression still reduced HIV incidence by -1.3% (95% CI, -2.6% to -.2%).CONCLUSIONS: To achieve the largest reductions in HIV, both prevalence of the risk factor and strength of association with HIV must be considered. Additionally, intervening on more risk factors may not necessarily result in larger reductions in HIV incidence.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Infektionsmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Infectious Medicine (hsv//eng)
Nyckelord
- adolescent girls and young women
- causal inference
- combination HIV prevention
- HIV
- South Africa
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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