Marie?Claude Boily|Michael Pickles|Catherine M Lowndes|Banadakoppa M Ramesh|Reynold Washington|Stephen Moses|Kathleen Deering|Kate Mitchell|Sushena Reza?Paul|James Blanchard|Anna Vassall|Michel Alary|Peter Vickerman
Positive impact of a large-scale HIV prevention programme among female sex workers and clients in South India
Imperial College London
estimate potential impact avahan india aids initiative among female sex workers fsws clients five districts karnataka state south indiaexamination time trends sexually transmitted infection stihiv prevalence serial crosssectional surveys combined mathematical modellingsurvey data district used monitor changes fsw stihiv prevalence avahan deterministic model parameterized districtspecific survey data used simulate hivhsv2syphilis transmission among highrisk groups district latin hypercube sampling used obtain multiple parameter sets reproduced districtspecific hiv prevalence trends bayesian framework tested whether selfreported increases consistent condom use ccu avahan compatible fsw hiv prevalence trends assuming slow preintervention rates ccu increases used estimate hiv incidence infections averteddeclines fsw hiv prevalence occurred 5 years districts statistically significant three selfreported increases ccu consistent observed declines hiv prevalence three districts five districts estimated 2564 3270 hiv infections averted among fsws clients 5 years corresponded 1422092 fsw infections averted depending district twofold ninefold among clientsempirical hiv prevalence trends combined bayesian modelling provided plausible evidence avahan reduced hiv transmission among fsws clients current ccu levels sustained fsw hiv prevalence could decline low levels 2015 many infections averted