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Impact of Varying Pre-exposure Prophylaxis Programs on HIV and Neisseria gonorrhoeae Transmission Among MSM in the

Maarten Reitsema1, Jacco Wallinga1, Ard I van Sighem2

  • 1Centre for Infectious Disease Control, National Institute for Public Health and Environment, Bilthoven, the Netherlands.

Journal of Acquired Immune Deficiency Syndromes (1999)
|August 22, 2024
PubMed
Abstract

Insights

The Dutch pre-exposure prophylaxis (PrEP) program significantly reduces HIV and Neisseria gonorrhea (NG) transmission among men who have sex with men (MSM). Increasing PrEP program capacity averts more infections, allowing for reduced consultation frequency without compromising effectiveness.

Area of Science:

  • Public Health
  • Epidemiology
  • Infectious Disease Prevention

Background:

  • A 5-year pre-exposure prophylaxis (PrEP) program for men who have sex with men (MSM) was initiated in the Netherlands in 2019.
  • The program provides PrEP and quarterly HIV/STI testing for up to 8,500 participants.

Purpose of the Study:

  • To assess the impact of the Dutch PrEP program on HIV and Neisseria gonorrhea (NG) transmission among MSM.
  • To examine prospective variations of the PrEP program beyond 2024.

Main Methods:

  • An agent-based model was employed to estimate the effects of the PrEP program.
  • Simulations explored varying program capacities (8,500, 12,000, 16,000 participants) and consultation frequencies (3-monthly, 6-monthly, mixed).

Main Results:

  • At 8,500 participants and 3-monthly consultations, the program averted an estimated 3,140 HIV and 27,930 NG infections.
  • Increasing capacity to 16,000 participants with 3-monthly or 6-monthly consultations yielded comparable averted infections but with significant differences in consultation numbers.
  • A capacity of 16,000 participants with 6-monthly consultations required substantially fewer consultations (272,590) compared to 3-monthly (589,330).

Conclusions:

  • Continuation of the PrEP program is projected to substantially reduce HIV and NG transmission.
  • Expanding program capacity can avert more infections.
  • Increased capacity allows for reduced consultation frequency without compromising the number of averted infections.

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