Likely impact of pre-exposure prophylaxis on HIV epidemics among men who have sex with men

Iryna B. Zablotska

doi:10.1071/SH16153

REVIEW (Open Access)

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Likely impact of pre-exposure prophylaxis on HIV epidemics among men who have sex with men

Iryna B. Zablotska

+ Author Affiliations

- Author Affiliations

The Kirby Institute, UNSW Australia, Sydney, NSW 2052, Australia. Email: izablotska@kirby.unsw.edu.au

Sexual Health 14(1) 97-105 https://doi.org/10.1071/SH16153
Submitted: 5 August 2016 Accepted: 20 September 2016 Published: 25 November 2016

Journal Compilation © CSIRO Publishing 2017 Open Access CC BY-NC-ND

Abstract

Rapid developments in the field of HIV pre-exposure prophylaxis (PrEP) with antiretrovirals offer a promise to bring HIV transmission among gay and other men who have sex with men (MSM) to zero by 2030. This review evaluates studies, which modelled the impact of PrEP on HIV diagnoses, and discusses the progress towards PrEP implementation. Studies in English, conducted after 2010 among MSM in countries of the Organization for Economic Cooperation and Development (OECD) were reviewed. Six modelling studies were included, three of which had been conducted outside the US. None of the published models showed that PrEP alone can reduce HIV diagnoses to zero and eliminate HIV transmission by 2030. However, PrEP in combination with other biomedical interventions can reduce HIV diagnoses on the population level by ~95%. Other upcoming biomedical prevention strategies may strengthen combination prevention. Access to PrEP remains limited, even in the OECD countries. Modelling studies can assist governments with decision-making about PrEP implementation and add urgency to the implementation of PrEP. More work is needed on modelling of the impact of PrEP on HIV diagnoses trends outside the US where PrEP implementation is in its early stages.

Additional keywords: combination prevention, effect, HIV/AIDS, implementation, mathematical model, pre-exposure prophylaxis (PrEP), review.

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