通过扩大使用多模式暴露前预防措施,在亚特兰大与男性发生性关系的男性中实现佐治亚州将艾滋病毒发病率降低25%的目标:一个数学模型
Achieving the state of Georgia 25% HIV incidence reduction target among men who have sex with men in Atlanta through expanded use of multimodal pre-exposure prophylaxis: A mathematical model.
作者信息
Fraysse Jeremy, Anderson Sarah-Jane, Smith Justin C, Matthews Derrick D, Sarkar Supriya, de Aragao Filipa, Blissett Rob
机构信息
ViiV Healthcare, Health Outcomes, The Netherlands.
GlaxoSmithKline, Value, Evidence & Outcomes, United Kingdom.
出版信息
PLoS One. 2025 Jan 9;20(1):e0312369. doi: 10.1371/journal.pone.0312369. eCollection 2025.
The US faces substantial demographic and geographic disparities in both HIV burden and access to pre-exposure prophylaxis (PrEP), an effective strategy to prevent HIV acquisition. Long-acting cabotegravir (CAB) is a novel, injectable PrEP option which demonstrated superior reduction in risk of HIV acquisition compared to daily-oral PrEP in the HPTN083 trial. We modelled the impact of increased PrEP initiations and the introduction of long-acting CAB on HIV incidence among men who have sex with men (MSM) in Atlanta, Georgia, a population with a high burden of HIV. The Georgia Department of Public Health has set an ambitious 25% HIV incidence reduction target, which could be reached with a daily-oral PrEP coverage of 42.2%. However, the target could be achieved at lower levels of PrEP coverage (34.6%) if a mix of PrEP modalities was used, such as an equal split of long-acting CAB PrEP and daily-oral PrEP. Our results clearly demonstrate that broadening access to new PrEP options has the potential to facilitate the achievement of public health HIV incidence reduction goals at plausible levels of PrEP coverage.
美国在艾滋病毒负担和获得暴露前预防(PrEP,一种预防艾滋病毒感染的有效策略)方面面临着巨大的人口统计学和地理差异。长效卡博特韦(CAB)是一种新型的注射用PrEP药物,在HPTN083试验中,与每日口服PrEP相比,它在降低艾滋病毒感染风险方面表现更优。我们对佐治亚州亚特兰大市男男性行为者(MSM)中增加PrEP的起始使用和引入长效CAB对艾滋病毒发病率的影响进行了建模,该人群艾滋病毒负担较高。佐治亚州公共卫生部设定了一个雄心勃勃的将艾滋病毒发病率降低25%的目标,每日口服PrEP覆盖率达到42.2%时可实现这一目标。然而,如果采用多种PrEP方式,如长效CAB PrEP和每日口服PrEP各占一半,那么在较低的PrEP覆盖率(34.6%)下也可实现该目标。我们的结果清楚地表明,扩大对新PrEP药物的获取途径有可能在合理的PrEP覆盖率水平上促进实现降低艾滋病毒发病率的公共卫生目标。
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