Rapid initiation of antiretroviral therapy in Turkey: a modeling study

Emine Yaylali*, Zikriye Melisa Erdogan, Fethi Calisir, Husnu Pullukcu, Figen Yildirim, Asuman Inan, Ozlem Altuntas Aydin, Suda Tekin, Meliha Cagla Sonmezer, Toros Sahin, Tahsin Gokcem Ozcagli, Berna Ozelgun

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: To effectively control the HIV epidemic and meet global targets, policymakers recommend the rapid initiation of antiretroviral therapy (ART). Our study aims to investigate the effect of rapid ART programs on individuals diagnosed with HIV, considering varying coverage and initiation days after diagnosis, and compare it to standard-of-care ART treatment in Turkey. Methods: We used a dynamic compartmental model to simulate the dynamics of HIV infection in Turkey. Rapid treatment, defined as initiation of ART within 7 days of diagnosis, was contrasted with standard-of-care treatment, which starts within 30 days of diagnosis. This study considered three coverage levels (10%, 50%, and 90%) and two rapid periods (7 and 14 days after diagnosis), comparing them to standard-of-care treatment in evaluating the number of HIV infections between 2020 and 2030. Results: Annual HIV incidence and prevalence for a 10-year period were obtained from model projections. In the absence of a rapid ART program, the model projected approximately 444,000 new HIV cases while the number of cases were reduced to 345,000 (22% reduction) with 90% of diagnosed cases included in the rapid ART program. Similarly, 10% and 50% rapid ART coverage has resulted in 3% and 13% reduction in HIV prevalence over a 10-year period. Conclusion: Rapid ART demonstrates the potential to mitigate the increasing HIV incidence in Turkey by reducing the number of infections. The benefit of the rapid ART program could be substantial when the coverage of the program reaches above a certain percentage of diagnosed population.

Original languageEnglish
Article number1224449
JournalFrontiers in Public Health
Volume12
DOIs
Publication statusPublished - 2024

Bibliographical note

Publisher Copyright:
Copyright © 2024 Yaylali, Erdogan, Calisir, Pullukcu, Yildirim, Inan, Aydin, Tekin, Sonmezer, Sahin, Ozcagli and Ozelgun.

Keywords

  • HIV care-continuum
  • HIV infections
  • infectious disease modeling
  • mathematical modeling
  • rapid antiretroviral treatment

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