Impact of varying pre-exposure prophylaxis programs on HIV and Neisseria gonorrhoeae transmission among MSM in the Netherlands: a modelling study.

IF 2.9 3区 医学 Q3 IMMUNOLOGY JAIDS Journal of Acquired Immune Deficiency Syndromes Pub Date : 2024-08-22 DOI:10.1097/QAI.0000000000003511
Maarten Reitsema, Jacco Wallinga, Ard I van Sighem, Daniela Bezemer, Marc van der Valk, Fleur van Aar, Janneke Cornelia Maria Heijne, Elske Hoornenborg, Ganna Rozhnova, Birgit van Benthem, Maria Xiridou
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Abstract

Background: In 2019, a five-year pre-exposure prophylaxis (PrEP) program started in the Netherlands, in which up to 8,500 men who have sex with men (MSM) can obtain PrEP and 3-monthly consultations with HIV/STI testing.

Setting: We assessed the impact of the PrEP program on transmission of HIV and Neisseria gonorrhea (NG) among MSM in the Netherlands and examined prospective variations of the program after 2024.

Methods: We used an agent-based model to estimate the effect of the PrEP program. For prospective PrEP programs from 2024, we varied the capacity (8,500; 12,000; 16,000 participants) and consultation frequency (3-monthly; 6-monthly; 70% 3-monthly and 30% 6-monthly) for t.

Results: At a capacity of 8,500 participants and 3-monthly consultations, the PrEP program could lead to 3,140 (95%CrI 1,780 - 4,780) and 27,930 (95%CrI 14,560 - 46,280) averted HIV and NG infections; requiring 316,050 (95%CrI 314,120 - 317,580) consultations. At a capacity of 16,000 participants the programs with 3-monthly consultations and 6-monthly consultations could lead to comparable numbers of averted HIV (3,940 (95%CrI 2,420 - 5,460), and 3,900 (2,320 - 5,630) respectively) and NG infections (29,970 (95%CrI 15,490 - 50,350), and 29,960 (95%CrI 13,610 - 50,620) respectively), while requiring substantially different numbers of consultations: 589,330 (95%CrI 586,240 - 591,160) and 272,590 (95%CrI 271,770 - 273,290) respectively.

Conclusion: Continuation of a PrEP program could lead to a substantial reduction in HIV and NG transmission. More infections could be averted if the number of participants is increased. In turn, the consultations frequency could be reduced without reducing the number of averted infections if capacity is increased.

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不同的暴露前预防方案对荷兰男男性行为者中艾滋病毒和淋病奈瑟菌传播的影响:一项模拟研究。
背景:2019年,一项为期五年的暴露前预防(PrEP)计划在荷兰启动,多达8500名男男性行为者(MSM)可在该计划中获得PrEP和3个月一次的HIV/STI检测咨询:我们评估了 PrEP 计划对荷兰 MSM 中 HIV 和淋病奈瑟菌(NG)传播的影响,并研究了 2024 年后该计划的前瞻性变化:我们使用基于代理的模型来估算 PrEP 计划的效果。对于 2024 年以后的前瞻性 PrEP 计划,我们改变了参与人数(8500 人;12000 人;16000 人)和咨询频率(3 个月;6 个月;70% 为 3 个月,30% 为 6 个月):如果参与人数为 8,500 人,咨询频率为 3 个月一次,PrEP 计划可避免 3,140 例(95%CrI 1,780 - 4,780 例)和 27,930 例(95%CrI 14,560 - 46,280 例)艾滋病毒和 NG 感染;需要 316,050 例(95%CrI 314,120 - 317,580 例)咨询。在 16,000 名参与者的容量下,每 3 个月咨询一次和每 6 个月咨询一次的方案可分别避免 3,940 例(95%CrI 为 2,420 - 5,460 例)和 3,900 例(2,320 - 5,630 例)艾滋病毒感染和 589,330 例(95%CrI 为 15,490 - 50,350 例)和 29,960 例(95%CrI 为 13,610 - 50,620 例),但所需咨询次数却大不相同:结论:继续实施 PrEP 计划可大幅减少 HIV 和 NG 的传播。如果增加参与人数,可以避免更多的感染。反过来,如果增加服务能力,就可以在不减少避免感染数量的情况下降低咨询频率。
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来源期刊
CiteScore
5.80
自引率
5.60%
发文量
490
审稿时长
3-6 weeks
期刊介绍: JAIDS: Journal of Acquired Immune Deficiency Syndromes​ seeks to end the HIV epidemic by presenting important new science across all disciplines that advance our understanding of the biology, treatment and prevention of HIV infection worldwide. JAIDS: Journal of Acquired Immune Deficiency Syndromes is the trusted, interdisciplinary resource for HIV- and AIDS-related information with a strong focus on basic and translational science, clinical science, and epidemiology and prevention. Co-edited by the foremost leaders in clinical virology, molecular biology, and epidemiology, JAIDS publishes vital information on the advances in diagnosis and treatment of HIV infections, as well as the latest research in the development of therapeutics and vaccine approaches. This ground-breaking journal brings together rigorously peer-reviewed articles, reviews of current research, results of clinical trials, and epidemiologic reports from around the world.
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