| Autor: |
Carla M. Doyle, Rachael M. Milwid, Joseph Cox, Yiqing Xia, Gilles Lambert, Cécile Tremblay, Joanne Otis, Marie‐Claude Boily, Jean‐Guy Baril, Réjean Thomas, Alexandre Dumont Blais, Benoit Trottier, Daniel Grace, David M. Moore, Sharmistha Mishra, Mathieu Maheu‐Giroux |
| Jazyk: |
angličtina |
| Rok vydání: |
2023 |
| Předmět: |
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| Zdroj: |
Journal of the International AIDS Society, Vol 26, Iss 12, Pp n/a-n/a (2023) |
| Druh dokumentu: |
article |
| ISSN: |
1758-2652 |
| DOI: |
10.1002/jia2.26194 |
| Popis: |
Abstract Introduction HIV pre‐exposure prophylaxis (PrEP) has been recommended and partly subsidized in Québec, Canada, since 2013. We evaluated the population‐level impact of PrEP on HIV transmission among men who have sex with men (MSM) in Montréal, Québec's largest city, over 2013–2021. Methods We used an agent‐based mathematical model of sexual HIV transmission to estimate the fraction of HIV acquisitions averted by PrEP compared to a counterfactual scenario without PrEP. The model was calibrated to local MSM survey, surveillance, and cohort data and accounted for COVID‐19 pandemic impacts on sexual activity, HIV prevention, and care. PrEP was modelled from 2013 onwards, assuming 86% individual‐level effectiveness. The PrEP eligibility criteria were: any anal sex unprotected by condoms (past 6 months) and either multiple partnerships (past 6 months) or multiple uses of post‐exposure prophylaxis (lifetime). To assess potential optimization strategies, we modelled hypothetical scenarios prioritizing PrEP to MSM with high sexual activity (≥11 anal sex partners annually) or aged ⩽45 years, increasing coverage to levels achieved in Vancouver, Canada (where PrEP is free‐of‐charge), and improving retention. Results Over 2013–2021, the estimated annual HIV incidence decreased from 0.4 (90% credible interval [CrI]: 0.3–0.6) to 0.2 (90% CrI: 0.1–0.2) per 100 person‐years. PrEP coverage among HIV‐negative MSM remained low until 2015 ( |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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