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
References
Mar 27, 1998·The New England Journal of Medicine·F J PalellaS D Holmberg
Nov 1, 2001·Proceedings of the National Academy of Sciences of the United States of America·G M OrtizD F Nixon
Apr 20, 2004·AIDS·Franco MaggioloFredy Suter
Jan 14, 2005·PLoS Medicine·Joshua A SalomonBernhard Schwartländer
Sep 13, 2005·Emerging Themes in Epidemiology·Rebecca F BaggaleyGeoff P Garnett
Dec 1, 2006·The New England Journal of Medicine·UNKNOWN Strategies for Management of Antiretroviral Therapy (SMART) Study GroupC Rappoport
Sep 12, 2007·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Frangiscos SifakisDavid D Celentano
Sep 20, 2007·PloS One·Ume L AbbasJohn W Mellors
Mar 14, 2008·PLoS Medicine·Timothy B HallettGeoff P Garnett
May 8, 2008·PloS One·Debby C J VissersSake J de Vlas
Aug 30, 2008·AIDS·Kamal DesaiPeter D McElroy
Feb 6, 2009·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·A David PaltielRochelle P Walensky
Mar 24, 2009·International Journal of STD & AIDS·S CurrieS Herman
Apr 3, 2009·The New England Journal of Medicine·Mari M KitahataUNKNOWN NA-ACCORD Investigators
Nov 26, 2010·The New England Journal of Medicine·Robert M GrantUNKNOWN iPrEx Study Team
Mar 1, 2011·Public Health Reports·Spencer LiebRobert M Malow
Aug 5, 2011·Public Health Reports·Christina G DorellDavid Yankey
Oct 4, 2011·AIDS and Behavior·Cathy MaulsbyDavid Holtgrave
Feb 16, 2012·AIDS·Ariane van der StratenDavid R Bangsberg
Jul 13, 2012·The New England Journal of Medicine·Jared M BaetenUNKNOWN Partners PrEP Study Team
Jul 13, 2012·The New England Journal of Medicine·Michael C ThigpenUNKNOWN TDF2 Study Group
Jul 24, 2012·Lancet·Chris BeyrerRon Brookmeyer
Oct 3, 2012·PloS One·Brandon D L MarshallSamuel R Friedman
Jul 31, 2014·PloS One·Steven M GoodreauSusan P Buchbinder
Aug 6, 2014·AIDS and Behavior·Cathy MaulsbyDavid Holtgrave
Nov 12, 2014·PloS One·Kristen UnderhillKenneth H Mayer
Jan 31, 2015·AIDS Care·Aadia I RanaIra B Wilson
Jul 21, 2015·The New England Journal of Medicine·UNKNOWN INSIGHT START Study GroupJames D Neaton
Jul 23, 2015·Journal of the International AIDS Society·Kenneth H MayerRobert Grant
Jul 16, 2016·The Journal of Infectious Diseases·Samuel M JennessPatrick Sullivan
Citations
Sep 2, 2018·AIDS and Behavior·Aimee DesrosiersMarc Siegel
Sep 20, 2018·AIDS Research and Human Retroviruses·Bobby J CalderThomas J Hope
Jul 10, 2018·PloS One·Jason R GantenbergBrandon D L Marshall
Oct 5, 2019·AIDS Patient Care and STDs·Philip A ChanBrandon D L Marshall
Jan 15, 2020·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Phillip KeenGarrett Prestage
May 3, 2018·Scientific Reports·Melanie StecherMartin Hoenigl
May 1, 2020·AIDS and Behavior·Elizabeth C PasipanodyaUNKNOWN and the California Collaborative Treatment Group (CCTG)
Jul 11, 2020·AIDS and Behavior·Carla M DoyleUNKNOWN Engage Study Team
Feb 26, 2020·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Julia L MarcusRochelle P Walensky
Sep 30, 2017·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Michael T LeVasseurSeth L Welles
Oct 11, 2017·AIDS·Elske HoornenborgKenneth H Mayer
Mar 30, 2020·Scientific Reports·William C GoedelKatie B Biello
Oct 27, 2017·Current HIV/AIDS Reports·Iryna B Zablotska, Catherine C O'Connor
Sep 19, 2020·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Linxuan WuUNKNOWN IMPACT Partner Collaborative
Dec 8, 2020·Frontiers in Microbiology·Mingchen LiuHong Shang
Jan 14, 2021·AIDS and Behavior·Savanah RussYu Liu
Jan 23, 2021·Journal of the International AIDS Society·Gordon ManserghPatrick Sullivan
Sep 11, 2020·AIDS·Samuel M JennessKevin P Delaney
Jan 15, 2020·The Journal of Sexual Medicine·Bryan A KutnerB R Simon Rosser
Dec 9, 2020·AIDS·Claudia EstcourtSharon Hutchinson
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
Jul 21, 2021·Scientific Reports·Diana M HendrickxAnne-Mieke Vandamme
Apr 23, 2021·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Christina M SchumacherUNKNOWN IMPACT Partner Collaborative
Jul 7, 2021·JMIR Public Health and Surveillance·Elizabeth MpungaLouis Masankha Banda