HIV in Newark, NJ
The first chapter of my PhD work focused on modeling interventions along the HIV care continuum in Newark, NJ. The HIV epidemic in Newark, New Jersey is among the most severe in the United States, with prevalence ranging up to 3.3% in some subpopulations. The aim of this project was to use a mathematical model of the epidemic in Newark to assess the impact of interventions along the continuum of care, leading to virologic suppression. A model was constructed of HIV infection including specific care-continuum steps.
Interventions assessed were increasing proportions tested, linked and retained in care, linked and adherent to treatment, and increasing testing frequency, high-risk-group testing, and adherence. The most effective interventions for reducing incidence were improving treatment adherence and increasing testing frequency and coverage. The most efficacious interventions for reducing deaths were increasing retention, linkage to care, testing coverage, and adherence.
Reducing HIV deaths in Newark over a 10-year period may be a realizable goal, but reducing incidence is less likely. Our results highlight the importance of addressing leaks across the entire continuum of care and reinforcing efforts to prevention new HIV infections with additional interventions.
This study was recently published in Clinical Infectious Diseases; a pdf is available here.