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Impact of pre-exposure prophylaxis uptake among gay, bisexual, and other men who have sex with men in urban centers in Brazil: a modeling study

BACKGROUND: Men who have sex with men (MSM) in Brazil remain disproportionately affected by HIV. We estimated the potential incidence reduction by five years with increased uptake of publicly-funded, daily, oral tenofovir/emtricitabine (TDF/FTC) for HIV pre-exposure prophylaxis (PrEP) among MSM usin...

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Autores principales: Luz, Paula M., Deshpande, Vijeta, Kazemian, Pooyan, Scott, Justine A., Shebl, Fatma M., Spaeth, Hailey, Pimenta, Cristina, Stern, Madeline, Pereira, Gerson, Struchiner, Claudio J., Grinsztejn, Beatriz, Veloso, Valdilea G., Freedberg, Kenneth A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10262537/
https://www.ncbi.nlm.nih.gov/pubmed/37308858
http://dx.doi.org/10.1186/s12889-023-15994-0
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author Luz, Paula M.
Deshpande, Vijeta
Kazemian, Pooyan
Scott, Justine A.
Shebl, Fatma M.
Spaeth, Hailey
Pimenta, Cristina
Stern, Madeline
Pereira, Gerson
Struchiner, Claudio J.
Grinsztejn, Beatriz
Veloso, Valdilea G.
Freedberg, Kenneth A.
author_facet Luz, Paula M.
Deshpande, Vijeta
Kazemian, Pooyan
Scott, Justine A.
Shebl, Fatma M.
Spaeth, Hailey
Pimenta, Cristina
Stern, Madeline
Pereira, Gerson
Struchiner, Claudio J.
Grinsztejn, Beatriz
Veloso, Valdilea G.
Freedberg, Kenneth A.
author_sort Luz, Paula M.
collection PubMed
description BACKGROUND: Men who have sex with men (MSM) in Brazil remain disproportionately affected by HIV. We estimated the potential incidence reduction by five years with increased uptake of publicly-funded, daily, oral tenofovir/emtricitabine (TDF/FTC) for HIV pre-exposure prophylaxis (PrEP) among MSM using the Cost Effectiveness of Preventing AIDS Complications microsimulation model. We used national data, local studies, and literature to inform model parameters for three cities: Rio de Janeiro, Salvador, and Manaus. RESULTS: In Rio de Janero, a PrEP intervention achieving 10% uptake within 60 months would decrease incidence by 2.3% whereas achieving 60% uptake within 24 months would decrease incidence by 29.7%; results were similar for Salvador and Manaus. In sensitivity analyses, decreasing mean age at PrEP initiation from 33 to 21 years increased incidence reduction by 34%; a discontinuation rate of 25% per year decreased it by 12%. CONCLUSION: Targeting PrEP to young MSM and minimizing discontinuation could substantially increase PrEP’s impact. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-023-15994-0.
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spelling pubmed-102625372023-06-15 Impact of pre-exposure prophylaxis uptake among gay, bisexual, and other men who have sex with men in urban centers in Brazil: a modeling study Luz, Paula M. Deshpande, Vijeta Kazemian, Pooyan Scott, Justine A. Shebl, Fatma M. Spaeth, Hailey Pimenta, Cristina Stern, Madeline Pereira, Gerson Struchiner, Claudio J. Grinsztejn, Beatriz Veloso, Valdilea G. Freedberg, Kenneth A. BMC Public Health Research Article BACKGROUND: Men who have sex with men (MSM) in Brazil remain disproportionately affected by HIV. We estimated the potential incidence reduction by five years with increased uptake of publicly-funded, daily, oral tenofovir/emtricitabine (TDF/FTC) for HIV pre-exposure prophylaxis (PrEP) among MSM using the Cost Effectiveness of Preventing AIDS Complications microsimulation model. We used national data, local studies, and literature to inform model parameters for three cities: Rio de Janeiro, Salvador, and Manaus. RESULTS: In Rio de Janero, a PrEP intervention achieving 10% uptake within 60 months would decrease incidence by 2.3% whereas achieving 60% uptake within 24 months would decrease incidence by 29.7%; results were similar for Salvador and Manaus. In sensitivity analyses, decreasing mean age at PrEP initiation from 33 to 21 years increased incidence reduction by 34%; a discontinuation rate of 25% per year decreased it by 12%. CONCLUSION: Targeting PrEP to young MSM and minimizing discontinuation could substantially increase PrEP’s impact. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-023-15994-0. BioMed Central 2023-06-13 /pmc/articles/PMC10262537/ /pubmed/37308858 http://dx.doi.org/10.1186/s12889-023-15994-0 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Luz, Paula M.
Deshpande, Vijeta
Kazemian, Pooyan
Scott, Justine A.
Shebl, Fatma M.
Spaeth, Hailey
Pimenta, Cristina
Stern, Madeline
Pereira, Gerson
Struchiner, Claudio J.
Grinsztejn, Beatriz
Veloso, Valdilea G.
Freedberg, Kenneth A.
Impact of pre-exposure prophylaxis uptake among gay, bisexual, and other men who have sex with men in urban centers in Brazil: a modeling study
title Impact of pre-exposure prophylaxis uptake among gay, bisexual, and other men who have sex with men in urban centers in Brazil: a modeling study
title_full Impact of pre-exposure prophylaxis uptake among gay, bisexual, and other men who have sex with men in urban centers in Brazil: a modeling study
title_fullStr Impact of pre-exposure prophylaxis uptake among gay, bisexual, and other men who have sex with men in urban centers in Brazil: a modeling study
title_full_unstemmed Impact of pre-exposure prophylaxis uptake among gay, bisexual, and other men who have sex with men in urban centers in Brazil: a modeling study
title_short Impact of pre-exposure prophylaxis uptake among gay, bisexual, and other men who have sex with men in urban centers in Brazil: a modeling study
title_sort impact of pre-exposure prophylaxis uptake among gay, bisexual, and other men who have sex with men in urban centers in brazil: a modeling study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10262537/
https://www.ncbi.nlm.nih.gov/pubmed/37308858
http://dx.doi.org/10.1186/s12889-023-15994-0
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