Faculty of Medicine and Health, the University of Sydney, Sydney, New South Wales, Australia.
The Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia.
PLoS One. 2018 Oct 18;13(10):e0204138. doi: 10.1371/journal.pone.0204138. eCollection 2018.
We estimated the size of the population of gay-identified men who have sex with men (gay men) eligible for PrEP in Australia under the current national PrEP guidelines. Using input indicators from the Australian Bureau of Statistics, the national representative survey Second Australian Study of Health and Relationships, and national HIV- behavioural surveillance, we calculated the size of the population of sexually active gay men and estimated a range for the number eligible for PrEP using different scenarios based on the guidelines. In 2015, an estimated 108,850 sexually-active 16-69-year-old gay men were classified as at risk of acquiring HIV in Australia. Of these men, 10,558 to 30,913 (9.7%-28.4%) were classified as being at high risk and therefore eligible for PrEP, most commonly due to recent receptive condomless intercourse with casual partners (6.1% to 15.5%), STI infections (5.4% to 10.6%) or the use of crystal methamphetamine (1.4% to 9.4%). The higher estimates included men who may have been at HIV risk for shorter time periods or with fewer partners. Australian PrEP guidelines recommend targeting PrEP to people at high HIV risk. Our estimation of potential PrEP users informed PrEP implementation in Australia. The choice of PrEP eligibility criteria, and interpretation of the guidelines, strongly affects the population estimates. In the future, higher numbers of gay men may become eligible for PrEP, because the estimates are largely defined by and follow trends in condomless anal intercourse. Our estimation methods can be adapted to other settings.
我们根据当前澳大利亚国家预防计划(PrEP)指南,估算了符合条件的澳大利亚男男性行为者(男同性恋者)人群的规模,他们可以使用 PrEP。使用澳大利亚统计局的输入指标、全国代表性调查《第二次澳大利亚健康与关系研究》以及国家 HIV 行为监测数据,我们计算了活跃的男同性恋者人群的规模,并根据指南基于不同的情景估算了有资格使用 PrEP 的人数范围。2015 年,澳大利亚有 108850 名 16-69 岁活跃的男同性恋者被认为有感染 HIV 的风险。在这些男性中,有 10558 到 30913 人(9.7%-28.4%)被认为有感染 HIV 的高风险,因此有资格使用 PrEP,最常见的原因是最近与偶然伴侣发生无保护措施的肛交(6.1%到 15.5%)、性传播感染(5.4%到 10.6%)或使用冰毒(1.4%到 9.4%)。较高的估计数包括可能处于 HIV 风险中时间较短或性伴侣较少的男性。澳大利亚 PrEP 指南建议将 PrEP 针对高 HIV 风险人群。我们对潜在 PrEP 用户的估算为澳大利亚的 PrEP 实施提供了信息。PrEP 资格标准的选择以及对指南的解释强烈影响了人群估计数。在未来,由于估计数主要由无保护肛交的趋势决定并随之变化,可能会有更多的男同性恋者有资格使用 PrEP。我们的估算方法可以适应其他环境。