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BMC Public Health
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Open Access 01-12-2023 | Human Immunodeficiency Virus | Research article

Impact of pre-exposure prophylaxis uptake among gay, bisexual, and other men who have sex with men in urban centers in Brazil: a modeling study

Authors: Paula M. Luz, Vijeta Deshpande, Pooyan Kazemian, Justine A. Scott, Fatma M. Shebl, Hailey Spaeth, Cristina Pimenta, Madeline Stern, Gerson Pereira, Claudio J. Struchiner, Beatriz Grinsztejn, Valdilea G. Veloso, Kenneth A. Freedberg

Published in: BMC Public Health | Issue 1/2023

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Abstract

Background

Men who have sex with men (MSM) in Brazil remain disproportionately affected by HIV. We estimated the potential incidence reduction by five years with increased uptake of publicly-funded, daily, oral tenofovir/emtricitabine (TDF/FTC) for HIV pre-exposure prophylaxis (PrEP) among MSM using the Cost Effectiveness of Preventing AIDS Complications microsimulation model. We used national data, local studies, and literature to inform model parameters for three cities: Rio de Janeiro, Salvador, and Manaus.

Results

In Rio de Janero, a PrEP intervention achieving 10% uptake within 60 months would decrease incidence by 2.3% whereas achieving 60% uptake within 24 months would decrease incidence by 29.7%; results were similar for Salvador and Manaus. In sensitivity analyses, decreasing mean age at PrEP initiation from 33 to 21 years increased incidence reduction by 34%; a discontinuation rate of 25% per year decreased it by 12%.

Conclusion

Targeting PrEP to young MSM and minimizing discontinuation could substantially increase PrEP’s impact.
Appendix
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Metadata
Title
Impact of pre-exposure prophylaxis uptake among gay, bisexual, and other men who have sex with men in urban centers in Brazil: a modeling study
Authors
Paula M. Luz
Vijeta Deshpande
Pooyan Kazemian
Justine A. Scott
Fatma M. Shebl
Hailey Spaeth
Cristina Pimenta
Madeline Stern
Gerson Pereira
Claudio J. Struchiner
Beatriz Grinsztejn
Valdilea G. Veloso
Kenneth A. Freedberg
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2023
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-023-15994-0

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