Even at suboptimal uptake, PrEP effective at preventing HIV in teen MSM

A recent modelling study has found that expanding current pre-exposure prophylaxis (PrEP) programmes and improving adherence rates can substantially lower HIV incidence among men who have sex with men (MSM).

The simulation included MSM aged 13–39 years. The model assumed that participants 19–39 years of age have had PrEP available for 3 years, and that coverage was at 20 percent. Adherence and retention rates in younger participants (aged 16–18 years) were drawn from the ATN113* and EPIC** studies, and partnerships across age groups were modeled using parameterization from previous studies.

Baseline PrEP adherence and retention rates were far from perfect for all MSM age subgroups and data sources. However, even such low rates translated to substantial numbers of infections averted (NIA).

In the modelling scenario focused on EPIC, for example, a control condition of 10-percent PrEP uptake could avert 4.0 percent of infections. Should uptake increase to 50 percent and 100 percent following mobile health interventions, the PrEP was projected to prevent 21.3 percent and 41.0 percent of infections.

In another modelling scenario, improving PrEP adherence and retention through a variety of focused interventions in real-world settings could help avoid 26 percent to 70 percent of infections.

“Our findings suggest that PrEP use among adolescent sexual minority males can significantly reduce HIV incidence despite suboptimal uptake, adherence, and retention,” the researchers said.

*Adolescent Medicine Trials Network for HIV/AIDS Interventions 113

**Enhancing Preexposure Prophylaxis in Community