Individual HIV Risk versus Population Impact of Risk Compensation after HIV Preexposure Prophylaxis Initiation among Men Who Have Sex with Men
Publication Date
January 06, 2017
Authors
Samuel M. Jenness, Akshay Sharma, Steven M. Goodreau, Eli S. Rosenberg, et al
Volume
12
Issue
1
Pages
e0169484
DOI
https://dx.plos.org/10.1371/journal.pone.0169484
Publisher URL
http://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0169484
Scopus
85009816974
Mendeley
http://www.mendeley.com/research/individual-hiv-risk-versus-population-impact-risk-compensation-after-hiv-preexposure-prophylaxis-ini-1
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Mendeley | Further Information

{"title"=>"Individual HIV risk versus population impact of risk compensation after HIV preexposure prophylaxis initiation among men who have sex with men", "type"=>"journal", "authors"=>[{"first_name"=>"Samuel M.", "last_name"=>"Jenness", "scopus_author_id"=>"35117728700"}, {"first_name"=>"Akshay", "last_name"=>"Sharma", "scopus_author_id"=>"55605770225"}, {"first_name"=>"Steven M.", "last_name"=>"Goodreau", "scopus_author_id"=>"8207010100"}, {"first_name"=>"Eli S.", "last_name"=>"Rosenberg", "scopus_author_id"=>"23995801600"}, {"first_name"=>"Kevin M.", "last_name"=>"Weiss", "scopus_author_id"=>"57192980257"}, {"first_name"=>"Karen W.", "last_name"=>"Hoover", "scopus_author_id"=>"35569459900"}, {"first_name"=>"Dawn K.", "last_name"=>"Smith", "scopus_author_id"=>"16141060900"}, {"first_name"=>"Patrick", "last_name"=>"Sullivan", "scopus_author_id"=>"7402033120"}], "year"=>2017, "source"=>"PLoS ONE", "identifiers"=>{"pmid"=>"28060881", "doi"=>"10.1371/journal.pone.0169484", "sgr"=>"85009816974", "isbn"=>"1111111111", "scopus"=>"2-s2.0-85009816974", "issn"=>"19326203", "pui"=>"614115667"}, "id"=>"be6e46a4-4b89-33a3-afd6-b647d3372f53", "abstract"=>"OBJECTIVES Risk compensation (RC) could reduce or offset the biological prevention benefits of HIV preexposure prophylaxis (PrEP) among those at substantial risk of infection, including men who have sex with men (MSM). We investigated the potential extent and causal mechanisms through which RC could impact HIV transmission at the population and individual levels. METHODS Using a stochastic network-based mathematical model of HIV transmission dynamics among MSM in the United States, we simulated RC as a reduction in the probability of condom use after initiating PrEP, with heterogeneity by PrEP adherence profiles and partnership type in which RC occurred. Outcomes were changes to population-level HIV incidence and individual-level acquisition risk. RESULTS When RC was limited to MSM highly/moderately adherent to PrEP, 100% RC (full replacement of condoms) resulted in a 2% relative decline in incidence compared to no RC, but an 8% relative increase in infection risk for MSM on PrEP. This resulted from confounding by indication: RC increased the number of MSM indicated for PrEP as a function of more condomless anal intercourse among men otherwise not indicated for PrEP; this led to an increased PrEP uptake and subsequent decline in incidence. CONCLUSIONS RC is unlikely to decrease the prevention impact of PrEP, and in some cases RC may be counterintuitively beneficial at the population level. This depended on PrEP uptake scaling with behavioral indications. Due to the increased acquisition risk associated with RC, however, clinicians should continue to support PrEP as a supplement rather than replacement of condoms.", "link"=>"http://www.mendeley.com/research/individual-hiv-risk-versus-population-impact-risk-compensation-after-hiv-preexposure-prophylaxis-ini-1", "reader_count"=>32, "reader_count_by_academic_status"=>{"Professor > Associate Professor"=>1, "Researcher"=>6, "Student > Doctoral Student"=>2, "Student > Ph. D. Student"=>5, "Student > Postgraduate"=>2, "Other"=>2, "Student > Master"=>3, "Student > Bachelor"=>9, "Professor"=>2}, "reader_count_by_user_role"=>{"Professor > Associate Professor"=>1, "Researcher"=>6, "Student > Doctoral Student"=>2, "Student > Ph. D. Student"=>5, "Student > Postgraduate"=>2, "Other"=>2, "Student > Master"=>3, "Student > Bachelor"=>9, "Professor"=>2}, "reader_count_by_subject_area"=>{"Unspecified"=>1, "Nursing and Health Professions"=>4, "Medicine and Dentistry"=>15, "Agricultural and Biological Sciences"=>2, "Philosophy"=>1, "Psychology"=>6, "Social Sciences"=>3}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>15}, "Social Sciences"=>{"Social Sciences"=>3}, "Psychology"=>{"Psychology"=>6}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>2}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>4}, "Unspecified"=>{"Unspecified"=>1}, "Philosophy"=>{"Philosophy"=>1}}, "group_count"=>6}

Scopus | Further Information

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