Prospects of HIV elimination among men who have sex with men: A systematic review of modeling studies
5 affiliations
- 1Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- 2Center for Complex Systems Studies (CCSS), Utrecht University, Utrecht, The Netherlands
- 3Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
- 4Faculty of Sciences, BioISI—Biosystems & Integrative Sciences Institute, University of Lisbon, Lisbon, Portugal
- 5Faculty of Sciences, University of Lisbon, Lisbon, Portugal
Abstract
Men who have sex with men (MSM) remain disproportionately affected by HIV worldwide. This systematic review summarizes the results of mathematical modeling studies that evaluated prospects of HIV elimination among MSM by geographical setting, type of intervention(s), elimination definition, and model characteristics. We searched Embase and PubMed for studies published between July 1, 2016 and September 1, 2025 which used a dynamic mathematical model to assess the impact of interventions on HIV transmission among MSM. Data were extracted on study population, interventions, elimination definitions, model type, model structure, and calibration. Studies were critically appraised for model comprehensiveness in addressing elimination. 135 of the 4,595 records were included. MSM populations in six of the eight Joint United Nations Programme on HIV/AIDS regions were modeled, with 47% of models considering MSM in the USA. Agent-based models (ABMs) were as common as compartmental models overall, with ABMs more frequently used in Western and Central Europe and North America (WCENA), while compartmental models predominated elsewhere. Of the 135 included studies, 41 defined elimination, and they defined it as follows: (i) reduction in HIV incidence/prevalence, or (ii) threshold of HIV incidence/prevalence, or (iii) reproduction number below one. Elimination was achieved in 42 out of 51 modeled scenarios, of which 32 (82.05%) were in WCENA, but the authors of only 28 of these 42 scenarios discussed the real-world elimination feasibility with 10 of these scenarios considered elimination feasible by the original authors. There was also a strong regional divide in the elimination scenarios considered feasible, with 6 (60.00%) in Asia and the Pacific (AP) and 4 (40.00%) in WCENA. Models in which elimination was achieved commonly used combinations of interventions. Modeling efforts to understand HIV elimination prospects outside WCENA should be intensified, and models assessing HIV elimination prospects should account for HIV acquisition outside of the local context. To enhance study comparability and ensure that models contribute effectively to public health policy, an elimination definition based on an HIV incidence threshold would be the most valuable. By identifying gaps in current studies, we recommend novel research directions for modeling to inform a coordinated global response for HIV elimination among MSM. Author summary: Men who have sex with men (MSM) continue to experience a disproportionate burden of HIV worldwide. The Joint United Nations Programme on HIV/AIDS (UNAIDS) strategy to end the AIDS epidemic by 2030 has intensified treatment and prevention efforts, yet it remains unclear whether these are sufficient to achieve HIV elimination in MSM. Public health decisions often rely on mathematical models, which estimate how different interventions might affect HIV transmission. We systematically reviewed dynamic modeling studies published between July 2016 and September 2025 to assess whether proposed interventions could eliminate HIV in MSM across different countries, intervention types, elimination definitions, and modeling approaches. Across studies, combinations of interventions were more likely than single interventions to achieve elimination under conditions that could realistically be implemented. Pre-exposure prophylaxis featured prominently in these scenarios, often alongside increased HIV testing and/or higher antiretroviral therapy coverage. Our review identified important research gaps, including limited modeling in many UNAIDS regions outside of Western and Central Europe and North America. Additionally, we found that studies used different definitions of elimination, making it difficult to compare results. To support clearer interpretation and more coordinated decision-making, we recommend using a common definition of elimination based on an HIV incidence threshold.
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BibTeX
@article{roberts2026prospects,
title = {{Prospects of HIV elimination among men who have sex with men: A systematic review of modeling studies}},
author = {Jacob Aiden Roberts and Alexandra Teslya and Mirjam E. Kretzschmar and Janneke H.H.M. van de Wijgert and Ganna Rozhnova},
journal = {PLOS Computational Biology},
year = {2026},
month = aug,
doi = {10.1371/journal.pcbi.1014596},
url = {https://journals.plos.org/ploscompbiol/article?id=10.1371/journal.pcbi.1014596},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Prospects of HIV elimination among men who have sex with men: A systematic review of modeling studies
AU - Jacob Aiden Roberts
AU - Alexandra Teslya
AU - Mirjam E. Kretzschmar
AU - Janneke H.H.M. van de Wijgert
AU - Ganna Rozhnova
PY - 2026
DA - 2026/08/31
JO - PLOS Computational Biology
DO - 10.1371/journal.pcbi.1014596
UR - https://journals.plos.org/ploscompbiol/article?id=10.1371/journal.pcbi.1014596
AB - Men who have sex with men (MSM) remain disproportionately affected by HIV worldwide. This systematic review summarizes the results of mathematical modeling studies that evaluated prospects of HIV elimination among MSM by geographical setting, type of intervention(s), elimination definition, and model characteristics. We searched Embase and PubMed for studies published between July 1, 2016 and September 1, 2025 which used a dynamic mathematical model to assess the impact of interventions on HIV transmission among MSM. Data were extracted on study population, interventions, elimination definitions, model type, model structure, and calibration. Studies were critically appraised for model comprehensiveness in addressing elimination. 135 of the 4,595 records were included. MSM populations in six of the eight Joint United Nations Programme on HIV/AIDS regions were modeled, with 47% of models considering MSM in the USA. Agent-based models (ABMs) were as common as compartmental models overall, with ABMs more frequently used in Western and Central Europe and North America (WCENA), while compartmental models predominated elsewhere. Of the 135 included studies, 41 defined elimination, and they defined it as follows: (i) reduction in HIV incidence/prevalence, or (ii) threshold of HIV incidence/prevalence, or (iii) reproduction number below one. Elimination was achieved in 42 out of 51 modeled scenarios, of which 32 (82.05%) were in WCENA, but the authors of only 28 of these 42 scenarios discussed the real-world elimination feasibility with 10 of these scenarios considered elimination feasible by the original authors. There was also a strong regional divide in the elimination scenarios considered feasible, with 6 (60.00%) in Asia and the Pacific (AP) and 4 (40.00%) in WCENA. Models in which elimination was achieved commonly used combinations of interventions. Modeling efforts to understand HIV elimination prospects outside WCENA should be intensified, and models assessing HIV elimination prospects should account for HIV acquisition outside of the local context. To enhance study comparability and ensure that models contribute effectively to public health policy, an elimination definition based on an HIV incidence threshold would be the most valuable. By identifying gaps in current studies, we recommend novel research directions for modeling to inform a coordinated global response for HIV elimination among MSM. Author summary: Men who have sex with men (MSM) continue to experience a disproportionate burden of HIV worldwide. The Joint United Nations Programme on HIV/AIDS (UNAIDS) strategy to end the AIDS epidemic by 2030 has intensified treatment and prevention efforts, yet it remains unclear whether these are sufficient to achieve HIV elimination in MSM. Public health decisions often rely on mathematical models, which estimate how different interventions might affect HIV transmission. We systematically reviewed dynamic modeling studies published between July 2016 and September 2025 to assess whether proposed interventions could eliminate HIV in MSM across different countries, intervention types, elimination definitions, and modeling approaches. Across studies, combinations of interventions were more likely than single interventions to achieve elimination under conditions that could realistically be implemented. Pre-exposure prophylaxis featured prominently in these scenarios, often alongside increased HIV testing and/or higher antiretroviral therapy coverage. Our review identified important research gaps, including limited modeling in many UNAIDS regions outside of Western and Central Europe and North America. Additionally, we found that studies used different definitions of elimination, making it difficult to compare results. To support clearer interpretation and more coordinated decision-making, we recommend using a common definition of elimination based on an HIV incidence threshold.
SN - 1553-7358
ER -