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Modelling the effects of structural interventions and social enablers on HIV incidence and mortality in sub-Saharan African countries

Guest Editors:
Charles Birungi: UNAIDS, Uganda
Timothy Hallett: Imperial College London, UK
Anne Stangl: Centers for Disease Control and Prevention, USA

The Editors of BMC Medicine together with BMC Infectious Diseases called for research articles on the modelling of structural interventions and social enablers on HIV incidence and mortality in sub-Saharan Africa. Two thirds of the world’s HIV infections are found in Sub-Saharan Africa, as such there is particular importance in the development of programmes to reduce HIV incidence and AIDS mortality. Well-designed interventions reducing HIV burden by addressing distal determinants of risk such as gender inequality, poverty, and laws that criminalize commercial sex and same-sex relationships will play a critical role in disease reduction and eradication.

Meet the Guest Editors

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Charles Birungi: UNAIDS, Uganda  

Dr Charles Birungi is an experienced economist working at the intersections of macroeconomics, public finance, and global health. Over the past 20 years, he has worked across research, program, policy and politics to drive change that matters. As the global lead for macroeconomic and fiscal policy at UNAIDS, his work focuses on influencing global and domestic health financing policies. He has expert-level understanding of when and how good economic analysis and advice meets good politics and lands well to translate hard headed but soft hearted policies into real-word change for people. He is a Ugandan national and holds a B.A (Economics) of Makerere University, a MSc in Health Services Management from Uganda Martyrs University, a MSc in Health Economics, Policy and Management from the London School of Economics and Political Science and a Ph.D. in Health Economics from University College London.

Timothy  Hallett: Imperial College London, UK  

Prof Timothy Hallet is Associate Director of the MRC Centre for Global Infectious Disease Analysis and a lead investigator at the Jameel Institute. He is also an  Affiliate Professor at the University of Washington, Department of Global Health, chair of the Modelling Guidance Group of The Global Fund and a Fellow of the Academy of Medical Sciences. During the last years, he founded and directed the HIV Modelling Consortium (a network of epidemiologists, statisticians and health-economists focussed on HIV in the highest burden settings) and chaired the UNAIDS Reference Group on Estimates, Modelling and Projections (which reviews and develops the official methods for calculating AIDS statistics).

Anne Stangl: Centers for Disease Control and Prevention, USA 

Dr Anne Stangl is the Senior Advisor for the Elimination of Stigma and Discrimination in the Division of Global HIV and TB at the U.S. Centers for Disease Control and Prevention. Anne is also Associate Faculty with the Department of International Health at the Johns Hopkins Bloomberg School of Public Health. She has over 20 years of international public health experience in Africa, Asia and the Caribbean. Her research focuses on understanding and addressing the social and structural determinants of health, including intersectional stigma, that impede access to and uptake of health services among underserved populations globally. Anne is a leading expert on health-related stigma and discrimination and has contributed to theoretical understanding of how the stigmatization process operates in the context of health. She is also actively engaged in utilizing research findings to inform global policy and action. She holds a Ph.D. in Public Health from Tulane University.

About the collection

Sub-Saharan Africa accounts for two thirds of the world’s HIV infections, and there have been substantial investments, from both international donors and African governments, in programmes to reduce HIV incidence and AIDS mortality. Mathematical models have played an important role in evaluating the impact of different prevention and treatment strategies in sub-Saharan Africa, in assessing which strategies are most cost-effective, and in influencing decisions about which programmes to prioritize. However, most mathematical models of HIV interventions have focused on proximate determinants of HIV risk (i.e. behavioural and biomedical risk factors) and associated interventions, such as antiretroviral treatment, HIV testing, pre-exposure prophylaxis, condom promotion and medical male circumcision. Few have considered the more distal determinants of HIV risk, such as gender inequality, poverty, and laws that criminalize commercial sex and same-sex relationships.

Although definitions vary, structural interventions can be broadly considered as interventions that alter the social, economic, legal and political environment that shapes health processes and outcomes. Social enablers tend to be defined more narrowly as social factors that affect uptake of health services. There is growing appreciation that structural interventions and interventions addressing social enablers may be critical to reducing HIV incidence, but evidence is weak and limited, as many structural interventions cannot be evaluated in individual-randomized experiments. There is also growing appreciation that in order for the HIV response to be sustained in the longer term, it needs to be more integrated into the current Sustainable Development Goals (SDG) framework, which emphasizes the structural factors that shape HIV risk. Funders are increasingly interested in quantifying the impact of these structural interventions.

Recognizing the growing interest in broadening the HIV response in sub-Saharan Africa, and the critical role that mathematical models can play in this regard, BMC Medicine and BMC Infectious Diseases come together to invite submissions of:

  • Original research describing mathematical models of structural drivers of HIV incidence and AIDS mortality in sub-Saharan Africa, and interventions to address these drivers;
  • Reviews of previously published models of structural interventions, with a focus on sub-Saharan Africa; and Commentaries on challenges associated with modelling and costing structural interventions, potentially with guidelines on how best to model structural interventions.

Image credit: National Cancer Institute/Unsplash

  1. Binge drinking, inequitable gender norms and sexual risk behaviour are closely interlinked. This study aims to model the potential effect of alcohol counselling interventions (in men and women) and gender-tran...

    Authors: Leigh F. Johnson, Mmamapudi Kubjane, Alex de Voux, Julius Ohrnberger and Mpho Tlali
    Citation: BMC Infectious Diseases 2023 23:500

Submission Guidelines

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This Collection welcomes submission of Research Articles. Before submitting your manuscript, please ensure you have read the submission guidelines of the journal you are submitting to (BMC Medicine & BMC Infectious Diseases). Articles for this Collection should be submitted via our submission systems  (BMC Medicine & BMC Infectious Diseases). During the submission process you will be asked whether you are submitting to a Collection, please select ["Modelling the effects of structural interventions and social enablers on HIV incidence and mortality  in sub-Saharan African countries"] from the dropdown menu.

Articles will undergo the standard peer-review process of the journal they are considered in (BMC Medicine & BMC Infectious Diseases) and are subject to all of the journal’s standard policies. Articles will be added to the Collection as they are published.

The Guest Editors have no competing interests with the submissions which they handle through the peer review process. The peer review of any submissions for which the Guest Editors have competing interests is handled by another Editorial Board Member who has no competing interests.