The Impact of Preexposure Prophylaxis Among Men Who Have Sex With Men: An Individual-Based Model

Journal of Acquired Immune Deficiency Syndromes : JAIDS
Parastu KasaieDavid W Dowdy

Abstract

Preexposure prophylaxis (PrEP) is recommended for preventing HIV infection among individuals at high risk, including men who have sex with men (MSM). Although its individual-level efficacy is proven, questions remain regarding population-level impact of PrEP implementation. We developed an agent-based simulation of HIV transmission among MSM, accounting for demographics, sexual contact network, HIV disease stage, and use of antiretroviral therapy. We use this framework to compare PrEP delivery strategies in terms of impact on HIV incidence and prevalence. The projected reduction in HIV incidence achievable with PrEP reflects both population-level coverage and individual-level adherence (as a proportion of days protected against HIV transmission). For example, provision of PrEP to 40% of HIV-negative MSM reporting more than one sexual partner in the last 12 months, taken with sufficient adherence to provide protection on 40% of days, can reduce HIV incidence by 9.5% (95% uncertainty range: 8%-11%) within 5 years. However, if this could be increased to 80% coverage on 80% of days (eg, through mass campaigns with a long-acting injectable formulation), a 43% (42%-44%) reduction in HIV incidence could be achieved. Delivering PrEP to...Continue Reading

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Citations

May 1, 2020·AIDS and Behavior·Elizabeth C PasipanodyaUNKNOWN and the California Collaborative Treatment Group (CCTG)
Feb 26, 2020·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Julia L MarcusRochelle P Walensky
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Jan 23, 2021·Journal of the International AIDS Society·Gordon ManserghPatrick Sullivan
Oct 22, 2018·The Lancet. HIV·Andrew E GrulichUNKNOWN Expanded PrEP Implementation in Communities New South Wales (EPIC-NSW) research group
May 10, 2021·AIDS and Behavior·Sophia BartelsClare Barrington
Apr 23, 2021·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Christina M SchumacherUNKNOWN IMPACT Partner Collaborative

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