Journal
JOURNAL OF INFECTIOUS DISEASES
Volume 223, Issue 1, Pages 72-82Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/infdis/jiaa552
Keywords
HIV; men who have sex with men; mathematical model; preexposure prophylaxis; sexual network
Categories
Funding
- National Institutes of Health [R21 MH112449, R01 AI138783, P30 AI050409]
Ask authors/readers for more resources
The study found that if 50% of people chose LAI-PrEP, 4.3% of infections could be averted over 10 years. LAI-PrEP is expected to have a slightly greater impact than the DO-PrEP-only regimen, especially with assumptions of higher adherence and partial protection after discontinuation. If the total PrEP initiation rate doubled, 17.1% of infections would be averted, pointing to the potential for increased population-level impact with higher PrEP coverage.
Background. Long-acting injectable (LAI) human immunodeficiency virus (HIV) preexposure prophylaxis (PrEP) is reportedly efficacious, although full trial results have not been published. We used a dynamic network model of HIV transmission among men who have sex with men to assess the population impact of LAI-PrEP when available concurrently with daily-oral (DO) PrEP. Methods. The reference model represents the current HIV epidemiology and DO-PrEP coverage (15% among those with behavioral indications for PrEP) among men who have sex with men in the southeastern United States. Primary analyses investigated varied PrEP uptake and proportion selecting LAI-PrEP. Secondary analyses evaluated uncertainty in pharmacokinetic efficacy and LAI-PrEP persistence relative to DO-PrEP. Results. Compared with the reference scenario, if 50% chose LAI-PrEP, 4.3% (95% simulation interval, -7.3% to 14.5%) of infections would be averted over 10 years. The impact of LAI-PrEP is slightly greater than that of the DO-PrEP-only regimen, based on assumptions of higher adherence and partial protection after discontinuation. If the total PrEP initiation rate doubled, 17.1% (95% simulation interval, 6.7%-26.4%) of infections would be averted. The highest population-level impact occurred when LAI-PrEP uptake and persistence improved. Conclusions. If LAI-PrEP replaces DO-PrEP, its availability will modestly improve the population impact. LAI-PrEP will make a more substantial impact if its availability drives higher total PrEP coverage, or if persistence is greater for LAI-PrEP.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available