clhchristine/Impact_of_HIV_ART_CC_Comparative_Modeling

Estimating the Effect of HIV and ART on Cervical Cancer Elimination in KwaZulu-Natal, South Africa: a comparative modeling analysis # Estimating the Effect of HIV and ART on Cervical Cancer Elimination in KwaZulu-Natal, South Africa: a comparative modeling analysis This repository contains model outputs for the DRIVE and Policy1-Cervix-HIV models between 1982 and 2124, with future projections beginning in 2024. Model outputs include HPV prevalence, cervical cancer incidence, cervical cancer case counts, HIV prevalence, and ART coverage. Model outputs are reported for different population subgroups (all women, HIV-negative, HIV-positive, HIV-positive and on ART, HIV-positive and untreated) and age groups (5-year age groups from 0 to 79). The DRIVE model presents the minimum, maximum, and median outputs of the 25 best-fitting parameter sets. The Policy1-Cervix-HIV model presents the median output. We modelled 8 scenarios: **S0: No HIV, no HIV-related interventions:** - No HIV. - VMMC and condom coverage in all years equal to low, pre-HIV levels. - No ART. - Vaccination begins in 2014. Bivalent vaccine until the end of 2023. Switch to the nonavalent vaccine in 2024. Vaccination coverage is 57%. - Screening starts in 2000. Once in a lifetime screening frequency at age 35-39 for all women (regardless of HIV status). Screening coverage is scaled up from 0% to 18% from 2000-2003, then 18% to 48% from 2003-2016. Hold at 48% for the rest of the time horizon. Screening with cytology. Treatment with cryotherapy/LLETZ (28% LTFU for colpo, 49% LTFU for follow up treatment for anyone with confirmed CIN). **S1: No HIV** - No HIV. - VMMC and condom coverage as historically observed. - No ART. - Vaccination and screening the same as above. **S2: HIV, no ART** - HIV turned on. - VMMC and condom coverage as historically observed. - No ART. - Vaccination and screening the same as above. **S3: HIV, observed ART (status quo)** - HIV turned on. - VMMC and condom coverage as historically observed. - ART coverage as observed (viral suppression for people living with HIV is 67% for females and 60% for males). - …