Punyacharoensin & White<\/a>) claims to be the first to model, on the basis of detailed behavioural and surveillance data, the\u00a0 impact of seven potential interventions \u2013 including PrEP \u2013 on HIV incidence in this population.\u00a0 There is a considerable\u00a0diversity in the nature of these interventions.\u00a0 One of them\u00a0consists in\u00a0the roll-out of the recent WHO policy of \u2018diagnose and treat\u2019: others in\u00a0the achievement of specific targets, such as yearly HIV testing for a given percentage of MSM: others again\u00a0in the fulfilment of what seem little more than\u00a0aspirations, given the\u00a0absence of any\u00a0indication of how\u00a0they might be achieved – such\u00a0as\u00a0halving\u00a0one-time partners or unprotected anal intercourse.\u00a0The potential impact of each intervention is assessed\u00a0independently,\u00a0and\u00a0then in various combinations with other interventions.<\/p>\nIt is evident from the way that the various\u00a0combinations of interventions are\u00a0grouped into two sequences that\u00a0the primary issue for these authors is\u00a0the potential\u00a0of PrEP (which\u00a0happens to be the only genuinely new tool in the box).\u00a0\u00a0The first sequence\u00a0combines PrEP at varying levels of coverage and effectiveness with the achievement of one-year testing for different proportions of the population, \u2018test and treat\u2019, and various levels of risk compensation.\u00a0\u00a0The second sequence\u00a0goes through much the same process but with PrEP now replaced by a putative 0.5 drop in repeat partnerships.\u00a0 The main study outcome appears to be\u00a0the demonstration that\u00a0introducing PrEP at certain levels of coverage and effectiveness could, in certain combinations, have an impact on incidence (-43.6%) that would be of the same order (-41%) as the achievement (by unspecified means) of\u00a0a putative 0.5 drop in repeat partnerships.<\/p>\n
The biggest problem for the modelers, of course, is the difficulty of predicting the effectiveness of PrEP in a real-life setting.\u00a0 When empirical evidence of this finally emerges, then the value of this intervention as against traditional interventions will presumably be determined by its relative cost-effectiveness.\u00a0 In other words, the question to confront health policy makers will be\u00a0how much of what they would otherwise\u00a0have spent on traditional interventions should be diverted into PrEP.<\/p>\n
In the meantime, if there is key message to emerge from this study, it is\u00a0that PrEP\u00a0is worth a try.<\/p>\n","protected":false},"excerpt":{"rendered":"
Despite the known preventative benefits of ART, the incidence of HIV among UK MSM population has remained relatively constant over the last 10 years and looks set to remain so. The UN 90:90:90 target will soon be achieved for this population, yet the goal of eliminating the infection seems no nearer.\u00a0 Not surprisingly there […]<\/p>\n
Read More…<\/a><\/p>\n","protected":false},"author":152,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[264,2713,2380],"tags":[],"class_list":["post-1162","post","type-post","status-publish","format-standard","hentry","category-health-policy","category-modelling","category-pre-exposure-prophylaxis"],"yoast_head":"\nModeling the potential effectiveness of PrEP as against other preventative interventions in addressing MSM HIV - Sexually Transmitted Infections<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/sti\/2016\/03\/01\/modeling-the-potential-effectiveness-of-prep-as-against-other-preventative-interventions-in-addressing-msm-hiv\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Modeling the potential effectiveness of PrEP as against other preventative interventions in addressing MSM HIV - Sexually Transmitted Infections\" \/>\n<meta property=\"og:description\" content=\" Despite the known preventative benefits of ART, the incidence of HIV among UK MSM population has remained relatively constant over the last 10 years and looks set to remain so. The UN 90:90:90 target will soon be achieved for this population, yet the goal of eliminating the infection seems no nearer.\u00a0 Not surprisingly there [...]Read More...\" \/>\n<meta property=\"og:url\" content=\"https:\/\/blogs.bmj.com\/sti\/2016\/03\/01\/modeling-the-potential-effectiveness-of-prep-as-against-other-preventative-interventions-in-addressing-msm-hiv\/\" \/>\n<meta property=\"og:site_name\" content=\"Sexually Transmitted Infections\" \/>\n<meta property=\"article:published_time\" content=\"2016-03-01T16:27:30+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2016-03-01T18:56:53+00:00\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"2 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/sti\\\/2016\\\/03\\\/01\\\/modeling-the-potential-effectiveness-of-prep-as-against-other-preventative-interventions-in-addressing-msm-hiv\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/sti\\\/2016\\\/03\\\/01\\\/modeling-the-potential-effectiveness-of-prep-as-against-other-preventative-interventions-in-addressing-msm-hiv\\\/\"},\"author\":{\"name\":\"\",\"@id\":\"\"},\"headline\":\"Modeling the potential effectiveness of PrEP as against other preventative interventions in addressing MSM HIV\",\"datePublished\":\"2016-03-01T16:27:30+00:00\",\"dateModified\":\"2016-03-01T18:56:53+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/sti\\\/2016\\\/03\\\/01\\\/modeling-the-potential-effectiveness-of-prep-as-against-other-preventative-interventions-in-addressing-msm-hiv\\\/\"},\"wordCount\":452,\"publisher\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/sti\\\/#organization\"},\"articleSection\":[\"health policy\",\"Modelling\",\"pre-exposure prophylaxis\"],\"inLanguage\":\"en-US\"},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/sti\\\/2016\\\/03\\\/01\\\/modeling-the-potential-effectiveness-of-prep-as-against-other-preventative-interventions-in-addressing-msm-hiv\\\/\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/sti\\\/2016\\\/03\\\/01\\\/modeling-the-potential-effectiveness-of-prep-as-against-other-preventative-interventions-in-addressing-msm-hiv\\\/\",\"name\":\"Modeling the potential effectiveness of PrEP as against other preventative interventions in addressing MSM HIV - 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