Assessing the Potential Effect of Antiretroviral Therapy Disruption on HIV Transmission Dynamics

BackgroundSustained access to antiretroviral therapy (ART) is central to controlling human immunodeficiency virus (HIV) transmission and reducing AIDS-related morbidity and mortality. Recent funding uncertainties and policy shifts, however, threaten the continuity of ART provision in several high-burden settings.MethodsA deterministic compartmental model was developed to investigate the epidemiological consequences of disruptions in ART funding on HIV transmission and disease progression. The model incorporates treatment-induced viral suppression, progression to AIDS, and differential infectiousness between treated and untreated individuals. Analytical results establish the existence of the disease-free and endemic equilibria and determine their stability, and the control reproduction number Rc is derived to characterize threshold dynamics. Sensitivity analysis using Latin hypercube sampling (LHS) and partial rank correlation coefficients (PRCCs) identifies key parameters influencing Rc.ResultsNumerical simulations indicate that reductions in ART coverage, even by 50%, can substantially increase the frequency of viral rebound, elevate HIV incidence, accelerate progression to AIDS, and raise HIV-related mortality. Sensitivity analysis highlights ART coverage, early treatment initiation, and viral suppression rates as the most salient factors driving epidemic outcomes. Temporary or sustained interruptions in ART funding can therefore reverse decades of treatment progress and trigger epidemic resurgence.ConclusionThe findings provide quantitative evidence to inform policy decisions, highlighting the importance of maintaining uninterrupted ART programs. Targeted interventions that sustain treatment coverage and enhance viral suppression are essential for long-term HIV control.