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Potential reasons for the decline of new HIV cases among people who inject drugs (PWID) in Kyrgyzstan

Abstract:
There has been a declining trend in the number of reported cases of human immunodeficiency virus (HIV) among people who inject drugs (PWID) in Kyrgyzstan. The local HIV and public health community has suggested that this decline may be driven by interventions targeting HIV transmission among PWID, changes in drug use patterns, or possible underreporting of new HIV cases. The present study aims to examine these hypotheses using a deterministic compartmental model. Three intervention scenarios were evaluated to assess their impact on PWID population trends, HIV incidence, and case reporting. Scenario I (baseline) included needle and syringe exchange programmes, opioid substitution therapy, behavioural interventions, and pre-exposure prophylaxis, collectively referred to as preventive interventions, alongside antiretroviral therapy (ART). Scenario II excluded preventive interventions while maintaining ART. Scenario III excluded both preventive interventions and ART. The model results suggest that the decline in PWID may be a key factor contributing to the reduction of the HIV epidemic in this group. While preventive interventions and ART are unlikely to have been the primary drivers of HIV incidence trends, they appear to have played a meaningful role in reducing the overall HIV burden. Furthermore, the model indicates that observed trends in reported HIV incidence are likely to reflect changes in testing behaviour rather than actual fluctuations in the number of new infections.
Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1371/journal.pone.0348970

Authors

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Institution:
University of Oxford
Role:
Author
ORCID:
0000-0002-3006-3737
More by this author
Institution:
University of Oxford
Role:
Author
More by this author
Institution:
University of Oxford
Role:
Author
More by this author
Role:
Author
ORCID:
0000-0001-8424-9396
More by this author
Institution:
University of Oxford
Role:
Author


Publisher:
Public Library of Science
Journal:
PLoS ONE More from this journal
Volume:
21
Issue:
5
Pages:
e0348970
Article number:
e0348970
Publication date:
2026-05-26
Acceptance date:
2026-04-23
DOI:
EISSN:
1932-6203
ISSN:
1932-6203


Language:
English
Source identifiers:
4083703
Deposit date:
2026-05-26
ARK identifier:
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