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Cost-effectiveness and impact of pre-exposure prophylaxis to prevent HIV among men who have sex with men in Asia: A modelling study

Ten Brink, Debra C ; Martin-Hughes, Rowan ; Minnery, Mark E ; Osborne, Aaron J ; Schmidt, Heather-Marie A ; Dalal, Shona ; Green, Kimberly E ; Ramaurtarsing, Reshmie ; Wilson, David P ; Kelly, Sherrie L Sharifi, Hamid

PloS one, 2022-05, Vol.17 (5), p.e0268240-e0268240 [Periódico revisado por pares]

United States: Public Library of Science

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Título:
Cost-effectiveness and impact of pre-exposure prophylaxis to prevent HIV among men who have sex with men in Asia: A modelling study
Autor: Ten Brink, Debra C ; Martin-Hughes, Rowan ; Minnery, Mark E ; Osborne, Aaron J ; Schmidt, Heather-Marie A ; Dalal, Shona ; Green, Kimberly E ; Ramaurtarsing, Reshmie ; Wilson, David P ; Kelly, Sherrie L
Sharifi, Hamid
Assuntos: Acquired immune deficiency syndrome ; AIDS ; Anti-HIV Agents - therapeutic use ; Biology and Life Sciences ; Care and treatment ; Cost analysis ; Cost-Benefit Analysis ; Demographic aspects ; Disease transmission ; Dosage ; Drug dosages ; Drugs, Generic - therapeutic use ; Economic aspects ; Epidemics ; Estimates ; Gays & lesbians ; Generic drugs ; Health aspects ; Health risks ; HIV ; HIV Infections - drug therapy ; HIV Infections - epidemiology ; HIV Infections - prevention & control ; HIV patients ; Homosexuality, Male ; Human immunodeficiency virus ; Humans ; Infections ; Male ; Medical tests ; Medicine and health sciences ; Mens health ; MSM (Men who have sex with men) ; People and Places ; Pre-Exposure Prophylaxis ; Prevention ; Prophylaxis ; Risk ; Risk taking ; Sexual and Gender Minorities ; Sexually transmitted diseases ; Social Sciences ; STD ; Thailand ; Transgender persons
É parte de: PloS one, 2022-05, Vol.17 (5), p.e0268240-e0268240
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
Competing Interests: The authors have declared that no competing interests exist.
Descrição: More than 70% of new HIV infections in Asia occurred in eight countries in 2020: Cambodia, China, India, Indonesia, Myanmar, Nepal, Thailand, and Vietnam-with a rising incidence among men who have sex with men (MSM). The World Health Organization (WHO) recommends pre-exposure prophylaxis (PrEP) for those at risk of acquiring HIV, yet wide-scale implementation of PrEP, on a daily or event-driven basis, has been limited in Asia. The Optima HIV model was applied to examine the impact of scaling-up PrEP over five-years to cover an additional 15% of MSM compared with baseline coverage, a target deemed feasible by regional experts. Based on behavioral survey data, we assume that covering 15% of higher-risk MSM will cover 30% of all sexual acts in this group. Scenarios to compare the impact of generic-brand daily dosing of PrEP with generic event-driven dosing (15 days a month) were modelled from the start of 2022 to the end of 2026. Cost-effectiveness of generic versus branded PrEP was also assessed for China, the only country with an active patent for branded, higher cost PrEP. The impact on new HIV infections among the entire population and cost per HIV-related disability-adjusted life year (DALY) averted were estimated from the beginning of 2022 to the end of 2031 and from 2022 to 2051. If PrEP were scaled-up to cover an additional 15% of MSM engaging in higher-risk behavior from the beginning of 2022 to the end of 2026 in the eight Asian countries considered, an additional 100,000 (66,000-130,000) HIV infections (17%) and 300,000 (198,000-390,000) HIV-related DALYs (3%) could be averted over the 2022 to 2031 period. The estimated cost per HIV-related DALY averted from 2022 to 2031 ranged from US$600 for event-driven generic PrEP in Indonesia to US$34,400 for daily branded PrEP in Thailand. Over a longer timeframe from 2022 to 2051, the cost per HIV-related DALY averted could be reduced to US$100-US$12,700. PrEP is a critical tool to further reduce HIV incidence in highly concentrated epidemics. Implementing PrEP in Asia may be cost-effective in settings with increasing HIV prevalence among MSM and if PrEP drug costs can be reduced, PrEP could be more cost-effective over longer timeframes.
Editor: United States: Public Library of Science
Idioma: Inglês

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Cost-effectiveness and impact of pre-exposure prophylaxis to prevent HIV among men who have sex with men in Asia: A modelling study

Ten Brink, Debra C ; Martin-Hughes, Rowan ; Minnery, Mark E ; Osborne, Aaron J ; Schmidt, Heather-Marie A ; Dalal, Shona ; Green, Kimberly E ; Ramaurtarsing, Reshmie ; Wilson, David P ; Kelly, Sherrie L Sharifi, Hamid

United States: Public Library of Science

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