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New strategies for prevention of HIV among Japanese men who have sex with men: a mathematical model

HIV prevalence in Japan continues to increase among men who have sex with men (MSM). We built a mathematical model to describe the HIV epidemic, including acute infection and pre-exposure prophylaxis (PrEP), and projected the model to 2050. We compared current testing and treatment policies, a scena...

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Detalles Bibliográficos
Autores principales: Gilmour, Stuart, Peng, Liping, Li, Jinghua, Oka, Shinichi, Tanuma, Junko
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7584662/
https://www.ncbi.nlm.nih.gov/pubmed/33097798
http://dx.doi.org/10.1038/s41598-020-75182-7
Descripción
Sumario:HIV prevalence in Japan continues to increase among men who have sex with men (MSM). We built a mathematical model to describe the HIV epidemic, including acute infection and pre-exposure prophylaxis (PrEP), and projected the model to 2050. We compared current testing and treatment policies, a scenario where Japan achieves UNAIDS 90-90-90 targets, three PrEP scenarios defined by different coverage levels of 25%, 50%, and 75% among the 20% of MSM with the highest risk behavior, and combinations of these scenarios. With no change in interventions prevalence of HIV among MSM will rise to 9.0% in 2050. If Japan achieves full UNAIDS 90-90-90 targets, 84.9% of these infections would be averted. Under 50% PrEP with no expansion of testing and treatment, prevalence will reach 2.6% and 62.1% of infections would be averted by 2050. If in addition UNAIDS 90-90-90 goals are achieved, 92.7% of HIV infections would be prevented by 2050. All interventions tested in this model were cost-saving relative to the base case. Both PrEP and enhanced ART strategies can be cost-saving, and if Japan enhances its testing program for MSM and introduces PrEP, it has the potential to effectively eliminate new infections in the next 30 years.