Evidence map›Paper›PMID 37439080›Full record

ArticleJournal of the International AIDS Society2023

Population-level impact of expanding PrEP coverage by offering long-acting injectable PrEP to MSM in three high-resource settings: a model comparison analysis.

Sarah E Stansfield, Jesse Heitner, Kate M Mitchell, Carla M Doyle, Rachael M Milwid, Mia Moore, Deborah J Donnell, Brett Hanscom, Yiqing Xia, Mathieu Maheu-Giroux and 5 more

Open access · goldAbstract read
In one paragraph

Article in Journal of the International AIDS Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
26citing papers in PubMed, 3 pooled it
5.4field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

26 citing papers in PubMed, 3 syntheses or guidelines pooled it, 28 citations in OpenAlex.

  1. Pooled it
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  3. A Review of Network Models for HIV Spread.Journal of acquired immune deficiency syndromes (1999) · 2025
    Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 8 institutions in 4 countries.

Sarah E StansfieldFred Hutchinson Cancer Center, Seattle, Washington, USA.ORCID 0000-0003-3251-8501
Jesse HeitnerMassachusetts General Hospital, Boston, Massachusetts, USA.
Kate M MitchellHIV Prevention Trials Network Modelling Centre, Imperial College London, London, UK.ORCID 0000-0002-7050-4787
Carla M DoyleDepartment of Epidemiology and Biostatistics, School of Population and Global Health, McGill University, Montréal, Québec, Canada.ORCID 0000-0001-5104-3068
Rachael M MilwidDepartment of Epidemiology and Biostatistics, School of Population and Global Health, McGill University, Montréal, Québec, Canada.
Mia MooreFred Hutchinson Cancer Center, Seattle, Washington, USA.
Deborah J DonnellFred Hutchinson Cancer Center, Seattle, Washington, USA.
Brett HanscomFred Hutchinson Cancer Center, Seattle, Washington, USA.
Yiqing XiaDepartment of Epidemiology and Biostatistics, School of Population and Global Health, McGill University, Montréal, Québec, Canada.
Mathieu Maheu-GirouxDepartment of Epidemiology and Biostatistics, School of Population and Global Health, McGill University, Montréal, Québec, Canada.ORCID 0000-0002-8363-4388
David van de VijverViroscience Department, Erasmus Medical Centre, Rotterdam, the Netherlands.ORCID 0000-0001-5877-8526
Haoyi WangViroscience Department, Erasmus Medical Centre, Rotterdam, the Netherlands.ORCID 0000-0002-1844-7156
Ruanne BarnabasMassachusetts General Hospital, Boston, Massachusetts, USA.
Marie-Claude BoilyMRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, UK.
Dobromir T DimitrovFred Hutchinson Cancer Center, Seattle, Washington, USA.
McGill University · CAFred Hutch Cancer Center · USMassachusetts General Hospital · USUniversity of Washington · USErasmus University Rotterdam · NLGlasgow Caledonian University · GBImperial College London · GBMaastricht University · NL

Funding

SDMC: HPTN 084 Pregnancy SupplementUM1AI068617 · NIAID · FRED HUTCHINSON CANCER RESEARCH CENTER · PI Elizabeth Renata Brown, Deborah J Donnell · 2011 to 2026
$204.9M
Medical Research Council MR/X020258/1NIAID NIH HHS UM1 AI068617
6 · The paper itself

Abstract

introductionLong-acting injectable cabotegravir (CAB-LA) demonstrated superiority to daily tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) for HIV pre-exposure prophylaxis (PrEP) in the HPTN 083/084 trials. We compared the potential impact of expanding PrEP coverage by offering CAB-LA to men who have sex with men (MSM) in Atlanta (US), Montreal (Canada) and the Netherlands, settings with different HIV epidemics.

methodsThree risk-stratified HIV transmission models were independently parameterized and calibrated to local data. In Atlanta, Montreal and the Netherlands, the models, respectively, estimated mean TDF/FTC coverage starting at 29%, 7% and 4% in 2022, and projected HIV incidence per 100 person-years (PY), respectively, decreasing from 2.06 to 1.62, 0.08 to 0.03 and 0.07 to 0.001 by 2042. Expansion of PrEP coverage was simulated by recruiting new CAB-LA users and by switching different proportions of TDF/FTC users to CAB-LA. Population effectiveness and efficiency of PrEP expansions were evaluated over 20 years in comparison to baseline scenarios with TDF/FTC only.

resultsIncreasing PrEP coverage by 11 percentage points (pp) from 29% to 40% by 2032 was expected to avert a median 36% of new HIV acquisitions in Atlanta. Substantially larger increases (by 33 or 26 pp) in PrEP coverage (to 40% or 30%) were needed to achieve comparable reductions in Montreal and the Netherlands, respectively. A median 17 additional PYs on PrEP were needed to prevent one acquisition in Atlanta with 40% PrEP coverage, compared to 1000+ in Montreal and 4000+ in the Netherlands. Reaching 50% PrEP coverage by 2032 by recruiting CAB-LA users among PrEP-eligible MSM could avert >45% of new HIV acquisitions in all settings. Achieving targeted coverage 5 years earlier increased the impact by 5-10 pp. In the Atlanta model, PrEP expansions achieving 40% and 50% coverage reduced differences in PrEP access between PrEP-indicated White and Black MSM from 23 to 9 pp and 4 pp, respectively.

conclusionsAchieving high PrEP coverage by offering CAB-LA can impact the HIV epidemic substantially if rolled out without delays. These PrEP expansions may be efficient in settings with high HIV incidence (like Atlanta) but not in settings with low HIV incidence (like Montreal and the Netherlands).

Indexed as

HIV InfectionsPre-Exposure ProphylaxisSexual and Gender MinoritiesBlack or African AmericanBlack PeopleCanadaDiketopiperazinesEmtricitabineGeorgiaHomosexuality, MaleHumansMaleNetherlandsPyridonesTenofovirWhitecabotegravirDiketopiperazinesEmtricitabinePyridonesTenofovirEuropeHIV preventionmen who have sex with menmodellingNorth AmericaPrEP

Identifiers

PMID37439080
PMCPMC10339001
OpenAlexW4384119959

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.