Skip to main content

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

Publication ,  Journal Article
Kasaie, P; Pennington, J; Shah, MS; Berry, SA; German, D; Flynn, CP; Beyrer, C; Dowdy, DW
Published in: J Acquir Immune Defic Syndr
June 1, 2017

OBJECTIVES: 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. DESIGN: 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. RESULTS: 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 MSM at high risk for HIV acquisition can augment population-level impact up to 1.8-fold. CONCLUSIONS: If highly ambitious targets for coverage and adherence can be achieved, PrEP can substantially reduce HIV incidence in the short-term. Although the reduction in HIV incidence largely reflects the proportion of person-years protected, the efficiency of PrEP delivery can be enhanced by targeting high-risk populations.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

J Acquir Immune Defic Syndr

DOI

EISSN

1944-7884

Publication Date

June 1, 2017

Volume

75

Issue

2

Start / End Page

175 / 183

Location

United States

Related Subject Headings

  • Young Adult
  • Virology
  • Sexual Behavior
  • Pre-Exposure Prophylaxis
  • Patient Simulation
  • Models, Theoretical
  • Middle Aged
  • Male
  • Humans
  • Homosexuality, Male
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Kasaie, P., Pennington, J., Shah, M. S., Berry, S. A., German, D., Flynn, C. P., … Dowdy, D. W. (2017). The Impact of Preexposure Prophylaxis Among Men Who Have Sex With Men: An Individual-Based Model. J Acquir Immune Defic Syndr, 75(2), 175–183. https://doi.org/10.1097/QAI.0000000000001354
Kasaie, Parastu, Jeff Pennington, Maunank S. Shah, Stephen A. Berry, Danielle German, Colin P. Flynn, Chris Beyrer, and David W. Dowdy. “The Impact of Preexposure Prophylaxis Among Men Who Have Sex With Men: An Individual-Based Model.J Acquir Immune Defic Syndr 75, no. 2 (June 1, 2017): 175–83. https://doi.org/10.1097/QAI.0000000000001354.
Kasaie P, Pennington J, Shah MS, Berry SA, German D, Flynn CP, et al. The Impact of Preexposure Prophylaxis Among Men Who Have Sex With Men: An Individual-Based Model. J Acquir Immune Defic Syndr. 2017 Jun 1;75(2):175–83.
Kasaie, Parastu, et al. “The Impact of Preexposure Prophylaxis Among Men Who Have Sex With Men: An Individual-Based Model.J Acquir Immune Defic Syndr, vol. 75, no. 2, June 2017, pp. 175–83. Pubmed, doi:10.1097/QAI.0000000000001354.
Kasaie P, Pennington J, Shah MS, Berry SA, German D, Flynn CP, Beyrer C, Dowdy DW. The Impact of Preexposure Prophylaxis Among Men Who Have Sex With Men: An Individual-Based Model. J Acquir Immune Defic Syndr. 2017 Jun 1;75(2):175–183.

Published In

J Acquir Immune Defic Syndr

DOI

EISSN

1944-7884

Publication Date

June 1, 2017

Volume

75

Issue

2

Start / End Page

175 / 183

Location

United States

Related Subject Headings

  • Young Adult
  • Virology
  • Sexual Behavior
  • Pre-Exposure Prophylaxis
  • Patient Simulation
  • Models, Theoretical
  • Middle Aged
  • Male
  • Humans
  • Homosexuality, Male