Modeling the Impact of PrEP Programs for Adolescent Sexual Minority Males Based on Empirical Estimates for the PrEP Continuum of Care.
Adolescent sexual minority
Agent-based network model
HIV
Pre-exposure prophylaxis
Journal
The Journal of adolescent health : official publication of the Society for Adolescent Medicine
ISSN: 1879-1972
Titre abrégé: J Adolesc Health
Pays: United States
ID NLM: 9102136
Informations de publication
Date de publication:
03 2021
03 2021
Historique:
received:
03
12
2019
revised:
24
06
2020
accepted:
25
06
2020
pubmed:
17
8
2020
medline:
6
7
2021
entrez:
17
8
2020
Statut:
ppublish
Résumé
Pre-exposure prophylaxis (PrEP)-an effective and safe intervention to prevent HIV transmission-was recently approved by the Food and Drug Administration for use by adolescents. Informed by studies of sexual behavior and PrEP adherence, retention, and promotion, we model the potential impact of PrEP use among at-risk adolescent sexual minority males. We simulate an HIV epidemic among men who have sex with men (MSM) aged 13-39. We assume adult MSM ages 19-39 have had PrEP available for 3 years with 20% coverage among eligible MSM based on the Centers for Disease Control and Prevention guidelines. PrEP interventions for ages 16-18 are then simulated using adherence and retention profiles drawn from the ATN113 and Enhancing Preexposure Prophylaxis in Community studies across a range of uptake parameters (10%-100%). Partnerships across age groups were modeled using parameterizations from the RADAR study. We compare the percent of incident infections averted (impact), person-years on PrEP per infection averted (efficiency), and changes in prevalence over 10 years. As compared to no PrEP use, baseline PrEP adherence and retention among adolescent sexual minority males drawn from the ATN113 and Enhancing Preexposure Prophylaxis in Community studies averted from 2.8% to 41.0% of HIV infections depending on the fraction of eligible adolescent sexual minority males that initiated PrEP at their annual health-care visit. Improved adherence and retention achieved with an array of focused interventions from real-world settings increased the percent of infections averted by as much as 26%-70%. Empirically demonstrated improvements in the PrEP continuum of care in response to existing interventions can substantially reduce incident HIV infections among adolescent sexual minority males.
Identifiants
pubmed: 32798099
pii: S1054-139X(20)30374-8
doi: 10.1016/j.jadohealth.2020.06.041
pmc: PMC7876162
mid: NIHMS1610191
pii:
doi:
Substances chimiques
Anti-HIV Agents
0
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
488-496Subventions
Organisme : NIAID NIH HHS
ID : P30 AI050409
Pays : United States
Organisme : NICHD NIH HHS
ID : R01 HD068395
Pays : United States
Organisme : NCHHSTP CDC HHS
ID : U38 PS004646
Pays : United States
Organisme : NICHD NIH HHS
ID : R24 HD042828
Pays : United States
Organisme : NICHD NIH HHS
ID : R21 HD075662
Pays : United States
Organisme : NIDA NIH HHS
ID : U01 DA036939
Pays : United States
Informations de copyright
Copyright © 2020 Society for Adolescent Health and Medicine. All rights reserved.
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