Optimizing HIV Partner Services for Gay, Bisexual, and Other Men Who Have Sex With Men Previously Diagnosed With HIV: A Modeling Study.

BACKGROUND

HIV Partner Services (HIV-PS) is a vital strategy for identifying and linking individuals to treatment and prevention; however, its population-level impact has been limited. This study investigated the potential impact of expanding HIV-PS to include previously diagnosed individuals and a broader sexual partner network in reducing HIV incidence among gay, bisexual, and other men who have sex with men (GBMSM).

METHODS

Stochastic network models were used to simulate HIV and bacterial sexually transmitted infection transmission within male same-sex partnerships in Atlanta. Two primary interventions were examined: prioritizing people with previously diagnosed HIV who were out-of-care (PWDH-OOC) in routine HIV-PS and expanding partner elicitation to include partners of HIV-positive partners of index cases. We quantified how modifications to HIV-PS cascade steps under these interventions would impact HIV incidence among GBMSM.

RESULTS

Expanded partner elicitation modestly increased the pool of partners eligible for linkage to transmission-disrupting services, with minimal impact on HIV incidence. In contrast, including PWDH-OOC led to a 10-fold increase in both index-case and partner pools. However, substantial reductions in HIV incidence required enhancements to other HIV-PS steps, particularly in partner identification and antiretroviral therapy (ART) reengagement for PWDH-OOC. Prioritizing ART reengagement for PWDH-OOC, alongside optimized HIV-PS, resulted in up to 63% of HIV infections being averted.

CONCLUSIONS

Our study highlights the potential of strategic improvements to HIV-PS for accelerating HIV incidence reduction among GBMSM. Synergistic optimization of HIV-PS, along with prioritizing ART reengagement for previously diagnosed individuals, will be essential for achieving substantial reductions in HIV incidence.