{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T21:59:48Z","timestamp":1790805588060,"version":"4.1.0"},"reference-count":30,"publisher":"BMJ","issue":"5","funder":[{"name":"Aidsfonds","award":["2014037"],"award-info":[{"award-number":["2014037"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2019,11,21]]},"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To investigate the impact and efficiency of combined testing for HIV and other STIs on HIV and STI transmission among men who have sex with men (MSM) and to assess what subgroups of MSM should be targeted for frequent testing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We developed an agent-based transmission model that simulates infection with HIV or<jats:italic>Neisseria gonorrhoeae<\/jats:italic>(NG) among MSM. We examined scenarios with increased percentages of MSM getting tested six\u2009monthly, among all MSM or only specific subgroups of MSM (defined according to recent gonorrhoea, number of partners and engagement in condomless anal intercourse (CAI)) and scenarios with reduced intervals between HIV\/STI tests.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The most efficient strategies were those with increased percentage of MSM getting tested every 6\u2009months among MSM with a recent gonorrhoea diagnosis; or among MSM who had CAI and \u226510 partners; or MSM who had \u226510 partners. Over 10 years, these strategies resulted in 387\u2013718 averted HIV infections and required 29\u2013164 additional HIV tests per averted HIV infection or one to seven additional gonorrhoea tests per averted NG infection. The most effective strategy in reducing HIV transmission was the one where the intervals between tests were reduced by half, followed by the strategy with increased percentage of MSM getting tested every 6\u2009months among all MSM. Over 10 years, these strategies resulted in 1362 and 1319 averted HIV infections, but required 663 and 584 additional HIV tests per averted HIV infection, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Targeting MSM with recent gonorrhoea diagnosis or MSM with many partners is efficient in terms of HIV\/STI tests needed to prevent new HIV or NG infections. Major reductions in HIV incidence can be achieved with consistent HIV\/STI testing every 6\u2009months among larger groups, including low-risk MSM. To impede HIV transmission, frequent testing should be combined with other prevention measures.<\/jats:p><\/jats:sec>","DOI":"10.1136\/sextrans-2018-053943","type":"journal-article","created":{"date-parts":[[2019,12,4]],"date-time":"2019-12-04T22:20:15Z","timestamp":1575498015000},"page":"361-367","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":14,"title":["Impact of frequent testing on the transmission of HIV and<i>N. gonorrhoeae<\/i>among men who have sex with men: a mathematical modelling study"],"prefix":"10.1136","volume":"96","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5524-1069","authenticated-orcid":false,"given":"Maarten","family":"Reitsema","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janneke","family":"Heijne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2607-7677","authenticated-orcid":false,"given":"Maartje","family":"Visser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ard","family":"van Sighem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maarten","family":"Schim van der Loeff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eline L M","family":"op de Coul","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Bezemer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacco","family":"Wallinga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birgit H B","family":"van Benthem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Xiridou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,12,4]]},"reference":[{"key":"2024092304150687000_96.5.361.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199803263381301"},{"key":"2024092304150687000_96.5.361.2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(13)70692-3"},{"key":"2024092304150687000_96.5.361.3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1105243"},{"key":"2024092304150687000_96.5.361.4","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.5148"},{"key":"2024092304150687000_96.5.361.5","unstructured":"World Health Organization . Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection: recommendations for a public health approach. World Health Organization, 2016."},{"key":"2024092304150687000_96.5.361.6","unstructured":"Skingsley A , Yin Z , Kirwan P , et al . HIV in the UK \u2013 situation report 2015: data to end 2014. November 2015. Public Health England, London. Available: https:\/\/assets.publishing.service.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/477702\/HIV_in_the_UK_2015_report.pdf [Accessed 12 Nov 2018]."},{"key":"2024092304150687000_96.5.361.7","unstructured":"Centers for Disease Control and Prevention . HIV testing in clinical settings. Available: https:\/\/www.cdc.gov\/hiv\/testing\/clinical\/index.html [Accessed 12 Nov 2018]."},{"key":"2024092304150687000_96.5.361.8","unstructured":"SOA AIDS Nederland . Strategy for the approach of STIs and HIV among MSM in the Netherlands 2013\u20132018. Amsterdam, the Netherlands: SOA AIDS Nederland 2013. In Dutch. Available: https:\/\/www.soaaids.nl\/sites\/default\/files\/documenten\/ManmetMan\/msm-meerjarenstrategie-onder-controle-2013.pdf"},{"key":"2024092304150687000_96.5.361.9","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1097\/00007435-200005000-00001","article-title":"Effect of coinfection with STDs and of STD treatment on HIV shedding in genital-tract secretions: systematic review and data synthesis","volume":"27","author":"Rotchford","year":"2000","journal-title":"Sex Transm Diseas"},{"key":"2024092304150687000_96.5.361.10","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0055312","article-title":"Increased HIV incidence in men who have sex with men despite high levels of ART-induced viral suppression: analysis of an extensively documented epidemic","volume":"8","author":"Phillips","year":"2013","journal-title":"PLoS One"},{"key":"2024092304150687000_96.5.361.11","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e3282fd167c"},{"key":"2024092304150687000_96.5.361.12","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0044819","article-title":"Resurgence of HIV infection among men who have sex with men in Switzerland: mathematical modelling study","volume":"7","author":"van Sighem","year":"2012","journal-title":"PLoS One"},{"key":"2024092304150687000_96.5.361.13","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0029098","article-title":"A mathematical model of comprehensive test-and-treat services and HIV incidence among men who have sex with men in the United States","volume":"7","author":"Sorensen","year":"2012","journal-title":"PLoS One"},{"key":"2024092304150687000_96.5.361.14","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir085"},{"key":"2024092304150687000_96.5.361.15","doi-asserted-by":"publisher","DOI":"10.1071\/SH08081"},{"key":"2024092304150687000_96.5.361.16","doi-asserted-by":"publisher","DOI":"10.1097\/QCO.0000000000000020"},{"key":"2024092304150687000_96.5.361.17","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1017\/S0950268818000092","article-title":"Current levels of gonorrhoea screening in MSM in Belgium may have little effect on prevalence: a modelling study","volume":"146","author":"Buyze","year":"2018","journal-title":"Epidemiol Infect"},{"key":"2024092304150687000_96.5.361.18","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1097\/OLQ.0000000000000876","article-title":"Estimated impact of screening on gonorrhea epidemiology in the United States: insights from a mathematical model","volume":"45","author":"Tuite","year":"2018","journal-title":"Sex Transm Dis"},{"key":"2024092304150687000_96.5.361.19","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1097\/OLQ.0b013e3181ca3c0a","article-title":"Frequent testing of highly sexually active gay men is required to control syphilis","volume":"37","author":"Gray","year":"2010","journal-title":"Sex Transm Diseas"},{"key":"2024092304150687000_96.5.361.20","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2017-053201"},{"key":"2024092304150687000_96.5.361.21","unstructured":"Visser M , van Aar F , van Oeffelen A , et al . Sexually transmitted infections including HIV, in the Netherlands in 2016. 2017, Bilthoven, the Netherlands. RIVM Report Number 2017:0003."},{"key":"2024092304150687000_96.5.361.22","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e32834f9d7c"},{"key":"2024092304150687000_96.5.361.23","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jis399"},{"key":"2024092304150687000_96.5.361.24","unstructured":"van Sighem AI , Boender TS , Wit F , et al . Monitoring report 2017. Human immunodeficiency virus infection in the Netherlands in 2016. Amsterdam: Stichting HIV monitoring, 2017. Available: www.hiv-monitoring.nl"},{"key":"2024092304150687000_96.5.361.25","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2018-022516","article-title":"Aids therapy evaluation in the Netherlands (ATHENA) national observational HIV cohort: cohort profile","volume":"8","author":"Boender","year":"2018","journal-title":"BMJ Open"},{"key":"2024092304150687000_96.5.361.26","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2016-052918"},{"key":"2024092304150687000_96.5.361.27","unstructured":"Van Empelen P , van Berkel M , Roos E , et al . Schorer monitor 2011. Amsterdam: Schorer."},{"key":"2024092304150687000_96.5.361.28","unstructured":"Den Daas C , Zuilhof W , van Bijnen A , et al . Report survey men and sexuality 2018. sex and health: the acting and thinking of MSM in the Netherlands. Joint report from the University of Utrecht, the National Institute of public health and environment, and Soa AIDS Nederland. available online. In Dutch. Available: https:\/\/www.soaaids.nl\/sites\/default\/files\/Rapport-SMS-Mannen-en-seksualiteit-MSM-Soa-Aids-Nederland-2018.pdf [Accessed 28 Nov 2018]."},{"key":"2024092304150687000_96.5.361.29","unstructured":"den Daas C , Zuilhof W , van Bijnen A , et al . Report survey men and sexuality 2018. Available: www.soaaids.nl\/nl\/sms2018 [Accessed 14 Jul 2019]."},{"key":"2024092304150687000_96.5.361.30","unstructured":"Aidsfonds . On the way to a world without AIDS. Amsterdam, 2018. Available: https:\/\/aidsfonds.nl\/nieuws\/nederland-naar-nul-nieuwe-hiv-infecties [Accessed 28 Nov 2018]."}],"container-title":["Sexually Transmitted Infections"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/sextrans-2018-053943","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,23]],"date-time":"2024-09-23T11:15:55Z","timestamp":1727090155000},"score":1,"resource":{"primary":{"URL":"https:\/\/sti.bmj.com\/lookup\/doi\/10.1136\/sextrans-2018-053943"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,12,4]]},"references-count":30,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2020,7,16]]},"published-print":{"date-parts":[[2020,8]]}},"alternative-id":["10.1136\/sextrans-2018-053943"],"URL":"https:\/\/doi.org\/10.1136\/sextrans-2018-053943","relation":{},"ISSN":["1368-4973","1472-3263"],"issn-type":[{"value":"1368-4973","type":"print"},{"value":"1472-3263","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,12,4]]}}}