Incidence of Gonorrhea and Chlamydia Following Human Immunodeficiency Virus Preexposure Prophylaxis Among Men Who Have Sex With Men: A Modeling Study

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
Samuel M JennessEli Rosenberg

Abstract

Preexposure prophylaxis (PrEP) is highly effective for preventing human immunodeficiency virus (HIV) infection, but risk compensation (RC) in men who have sex with men (MSM) raises concerns about increased sexually transmitted infections (STIs). The Center for Disease Control and Prevention's (CDC's) PrEP guidelines recommend biannual STI screening, which may reduce incidence by treating STIs that would otherwise remain undiagnosed. We investigated these two counteracting phenomena. With a network-based mathematical model of HIV, Neisseria gonorrhoeae (NG), and Chlamydia trachomatis (CT) transmission dynamics among MSM in the United States, we simulated PrEP uptake following the prescription indications and HIV/STI screening recommendations in the CDC guidelines. Scenarios varied PrEP coverage (the proportion of MSM indicated for PrEP who received it), RC (a reduction in the per-act probability of condom use), and the STI screening interval. In our reference scenario (40% coverage, 40% RC), 42% of NG and 40% of CT infections would be averted over the next decade. A doubling of RC would still result in net STI prevention relative to no PrEP. STIs declined because PrEP-related STI screening resulted in a 17% and 16% absolute incr...Continue Reading

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Citations

Jan 26, 2018·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Samuel M JennessEli S Rosenberg
Oct 14, 2017·Open Forum Infectious Diseases·Douglas S KrakowerKenneth H Mayer
Jan 26, 2018·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Chris Kenyon
Jul 20, 2018·American Journal of Public Health·Julia L MarcusKenneth H Mayer
May 23, 2018·Sexually Transmitted Diseases·Trang Quyen NguyenStephanie E Cohen
Jul 10, 2018·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Aaron J SieglerPatrick S Sullivan
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Apr 10, 2019·JAMA : the Journal of the American Medical Association·Michael W TraegerUNKNOWN PrEPX Study Team
May 17, 2019·AIDS Patient Care and STDs·Sarit A Golub, Julie E Myers
Aug 29, 2019·Journal of the International AIDS Society·Maria N PyraJared M Baeten
Aug 31, 2019·Journal of the International AIDS Society·Daniela Rojas CastroJean-Michel Molina
Nov 26, 2019·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Christina SchumacherUNKNOWN IMPACT Partner Collaborative
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