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dc.contributor.authorRozhnova, Gannaen
dc.contributor.authorHeijne, Jannekeen
dc.contributor.authorBezemer, Danielaen
dc.contributor.authorvan Sighem, Arden
dc.contributor.authorPresanis, Anneen
dc.contributor.authorDe Angelis, Danielaen
dc.contributor.authorKretzschmar, Mirjamen
dc.date.accessioned2018-12-20T00:31:22Z
dc.date.available2018-12-20T00:31:22Z
dc.date.issued2018-11en
dc.identifier.issn0269-9370
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/287243
dc.description.abstractOBJECTIVE: Preexposure prophylaxis (PrEP) is a promising intervention to help end the HIV epidemic among men who have sex with men (MSM) in the Netherlands. We aimed to assess the impact of PrEP on HIV prevalence in this population and to determine the levels of PrEP coverage necessary for HIV elimination. DESIGN AND METHODS: We developed a mathematical model of HIV transmission in a population stratified by sexual risk behavior with universal antiretroviral treatment (ART) and daily PrEP use depending on an individual's risk behavior. We computed the effective reproduction number, HIV prevalence, ART and PrEP coverage for increasing ART and PrEP uptake levels, and examined how these were affected by PrEP effectiveness and duration of PrEP use. RESULTS: At current levels of ART coverage of 80%, PrEP effectiveness of 86% and PrEP duration of 5 years, HIV elimination required 82% PrEP coverage in the highest risk group (12 000 MSM with more than 18 partners per year). If ART coverage increased by 9%, the elimination threshold was at 70% PrEP coverage. For shorter PrEP duration and lower effectiveness elimination prospects were less favorable. For the same number of PrEP users distributed among two groups with highest risk behavior, prevalence dropped from the current 8 to 4.6%. CONCLUSION: PrEP for HIV prevention among MSM could, in principle, eliminate HIV from this population in the Netherlands. The highest impact of PrEP on prevalence was predicted when ART and PrEP coverage increased simultaneously and PrEP was used by the highest risk individuals.
dc.format.mediumPrinten
dc.languageengen
dc.rightsAttribution 4.0 International
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.subjectHumansen
dc.subjectHIV Infectionsen
dc.subjectPrevalenceen
dc.subjectModels, Statisticalen
dc.subjectHomosexuality, Maleen
dc.subjectCommunicable Disease Controlen
dc.subjectNetherlandsen
dc.subjectMaleen
dc.subjectDisease Transmission, Infectiousen
dc.subjectEpidemicsen
dc.subjectDisease Eradicationen
dc.subjectPre-Exposure Prophylaxisen
dc.titleElimination prospects of the Dutch HIV epidemic among men who have sex with men in the era of preexposure prophylaxis.en
dc.typeArticle
prism.endingPage2623
prism.issueIdentifier17en
prism.publicationDate2018en
prism.publicationNameAIDS (London, England)en
prism.startingPage2615
prism.volume32en
dc.identifier.doi10.17863/CAM.34550
dcterms.dateAccepted2018-09-18en
rioxxterms.versionofrecord10.1097/qad.0000000000002050en
rioxxterms.versionVoR
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserveden
rioxxterms.licenseref.startdate2018-11en
dc.contributor.orcidRozhnova, Ganna [0000-0002-6725-7359]
dc.contributor.orcidPresanis, Anne [0000-0003-3078-4427]
dc.contributor.orcidDe Angelis, Daniela [0000-0001-6619-6112]
dc.contributor.orcidKretzschmar, Mirjam [0000-0002-4394-7697]
dc.identifier.eissn1473-5571
rioxxterms.typeJournal Article/Reviewen


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Attribution 4.0 International
Except where otherwise noted, this item's licence is described as Attribution 4.0 International