Achieving the state of Georgia 25% HIV incidence reduction target among men who have sex with men in Atlanta through expanded use of multimodal pre-exposure prophylaxis: A mathematical model.

Jeremy Fraysse, Sarah-Jane Anderson, Justin C Smith, Derrick D Matthews, Supriya Sarkar, Filipa de Aragao, Rob Blissett
Author Information
  1. Jeremy Fraysse: ViiV Healthcare, Health Outcomes, The Netherlands. ORCID
  2. Sarah-Jane Anderson: GlaxoSmithKline, Value, Evidence & Outcomes, United Kingdom.
  3. Justin C Smith: Campaign to End AIDS at Positive Impact Health Centers, Georgia, United States of America.
  4. Derrick D Matthews: Weitzman Institute, Moses/Weitzman Health System, United States of America.
  5. Supriya Sarkar: ViiV Healthcare, Epidemiology & Real-World Evidence, Durham, NC, United States of America.
  6. Filipa de Aragao: NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal.
  7. Rob Blissett: Maple Health Group, LLC, New York, United States of America.

Abstract

The US faces substantial demographic and geographic disparities in both HIV burden and access to pre-exposure prophylaxis (PrEP), an effective strategy to prevent HIV acquisition. Long-acting cabotegravir (CAB) is a novel, injectable PrEP option which demonstrated superior reduction in risk of HIV acquisition compared to daily-oral PrEP in the HPTN083 trial. We modelled the impact of increased PrEP initiations and the introduction of long-acting CAB on HIV incidence among men who have sex with men (MSM) in Atlanta, Georgia, a population with a high burden of HIV. The Georgia Department of Public Health has set an ambitious 25% HIV incidence reduction target, which could be reached with a daily-oral PrEP coverage of 42.2%. However, the target could be achieved at lower levels of PrEP coverage (34.6%) if a mix of PrEP modalities was used, such as an equal split of long-acting CAB PrEP and daily-oral PrEP. Our results clearly demonstrate that broadening access to new PrEP options has the potential to facilitate the achievement of public health HIV incidence reduction goals at plausible levels of PrEP coverage.

References

  1. J Acquir Immune Defic Syndr. 2021 Feb 1;86(2):191-199 [PMID: 33109935]
  2. Clin Infect Dis. 2020 Jul 27;71(3):574-582 [PMID: 31499518]
  3. Cost Eff Resour Alloc. 2012 Jul 18;10(1):9 [PMID: 22808944]
  4. Ann Epidemiol. 2018 Dec;28(12):865-873 [PMID: 29753640]
  5. JAMA. 2023 Aug 22;330(8):736-745 [PMID: 37606666]
  6. AIDS Care. 2017 Nov;29(11):1351-1358 [PMID: 28286983]
  7. HIV Med. 2023 Jun;24(6):653-663 [PMID: 36468218]
  8. Viruses. 2023 Jun 13;15(6): [PMID: 37376664]
  9. BMJ Open. 2022 May 11;12(5):e048478 [PMID: 35545381]
  10. BMJ Open Qual. 2022 May;11(2): [PMID: 35551096]
  11. Lancet Reg Health Am. 2023 Jan 17;18:100416 [PMID: 36844011]
  12. BMC Public Health. 2023 Apr 20;23(1):716 [PMID: 37081482]
  13. AIDS Behav. 2017 May;21(5):1336-1349 [PMID: 27770215]
  14. AIDS Educ Prev. 2020 Aug;32(4):311-324 [PMID: 32897130]
  15. Lancet HIV. 2018 Sep;5(9):e498-e505 [PMID: 29908917]
  16. J Infect Dis. 2021 Jan 4;223(1):72-82 [PMID: 32882043]
  17. AIDS Behav. 2019 Jan;23(1):105-115 [PMID: 30171452]
  18. JAMA. 2019 Jun 11;321(22):2214-2230 [PMID: 31184746]
  19. AIDS Behav. 2018 Apr;22(4):1158-1164 [PMID: 29119472]
  20. AIDS Behav. 2019 Jul;23(7):1917-1924 [PMID: 30600456]
  21. AIDS Behav. 2018 Nov;22(11):3627-3636 [PMID: 29589137]
  22. N Engl J Med. 2021 Aug 12;385(7):595-608 [PMID: 34379922]
  23. J Int AIDS Soc. 2023 Jul;26 Suppl 2:e26109 [PMID: 37439080]
  24. J Acquir Immune Defic Syndr. 2015 Apr 1;68(4):439-48 [PMID: 25501614]
  25. J Acquir Immune Defic Syndr. 2021 Jul 1;87(3):937-943 [PMID: 33734099]
  26. Cult Health Sex. 2018 Jul;20(7):772-786 [PMID: 28982311]
  27. Glob Health Sci Pract. 2013 Jul 26;1(2):203-12 [PMID: 25276533]

MeSH Term

Humans
Male
HIV Infections
Pre-Exposure Prophylaxis
Georgia
Homosexuality, Male
Incidence
Models, Theoretical
Anti-HIV Agents
Pyridones
Adult
Diketopiperazines

Chemicals

Anti-HIV Agents
Pyridones
cabotegravir
Diketopiperazines

Word Cloud

Created with Highcharts 10.0.0PrEPHIVreductionincidencemenCABdaily-oralGeorgiatargetcoverageburdenaccesspre-exposureacquisitionlong-actingamongsexAtlanta25%levelsUSfacessubstantialdemographicgeographicdisparitiesprophylaxiseffectivestrategypreventLong-actingcabotegravirnovelinjectableoptiondemonstratedsuperiorriskcomparedHPTN083trialmodelledimpactincreasedinitiationsintroductionMSMpopulationhighDepartmentPublicHealthsetambitiousreached422%Howeverachievedlower346%mixmodalitiesusedequalsplitresultsclearlydemonstratebroadeningnewoptionspotentialfacilitateachievementpublichealthgoalsplausibleAchievingstateexpandedusemultimodalprophylaxis:mathematicalmodel

Similar Articles

Cited By