Evidence map›Paper›PMID 42458454›Full record

ArticleBMC health services research2026

Evaluating mental health integration in PrEP programs to reduce HIV incidence among US gay and bisexual men: a network modeling study.

Udodirim N Onwubiko, Adrien Le Guillou, Allison T Chamberlain, David Benkeser, David P Holland, Stefan D Baral, Samuel M Jenness

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Article in BMC health services research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Udodirim N OnwubikoDepartment of Epidemiology, Rollins School of Public Health, Emory University, Atlanta Georgia, USA. udodirim.n.onwubiko@gmail.com.ORCID https://orcid.org/0000-0001-8223-5716
Adrien Le GuillouDepartment of Epidemiology, Rollins School of Public Health, Emory University, Atlanta Georgia, USA.
Allison T ChamberlainDepartment of Epidemiology, Rollins School of Public Health, Emory University, Atlanta Georgia, USA.
David BenkeserDepartment of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta Georgia, USA.
David P HollandFulton County Board of Health, Atlanta Georgia, USA.
Stefan D BaralCenter for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA.
Samuel M JennessDepartment of Epidemiology, Rollins School of Public Health, Emory University, Atlanta Georgia, USA.

Funding

Integrating the Visualization and Use of Stigma Data to Maximize the Impact of the Ending the HIV Epidemic InitiativeR01MH132150 · NIMH · JOHNS HOPKINS UNIVERSITY · PI Stefan David Baral · 2022 to 2026
$5.1M
STI Response and Recommendations Under PrEP (STIRRUP)R01MH128130 · NIMH · EMORY UNIVERSITY · PI Samuel Jenness · 2022 to 2026
$3.1M
NIH HHS R01MH128130NIH HHS R01MH132150NIMH NIH HHS R01 MH128130NIMH NIH HHS R01 MH132150
6 · The paper itself

Abstract

backgroundDespite advances in HIV prevention, achieving elimination in the United States (US) remains challenging, particularly among gay, bisexual, and other men who have sex with men (GBMSM). Psychosocial barriers, including stigma and mental health challenges, influence sexual behaviors and hinder engagement in HIV prevention and care, suggesting that integrated interventions may improve HIV-related service uptake and reduce HIV incidence.

methodsWe adapted a stochastic network model simulating HIV transmission dynamics in a southeastern US metro to include individual-level sexual stigma and mental health factors impacting HIV risk and service engagement. The model assessed the impact of integrating routine mental health screening and resilience-building mental health care into PrEP programs and evaluated intervention effects on HIV incidence over ten years.

resultsEnhancements in mental health services alone led to modest reductions in HIV incidence, averting 12% of new infections with maximum improvements in depression diagnosis and treatment initiation across the general GBMSM population. However, integrated strategies combining mental health care with expanded PrEP and ART coverage resulted in up to a 41% reduction in HIV incidence when targeted at all HIV-negative individuals within PrEP settings, reaching a final-year incidence rate of 0.52 per 100 person-years.

conclusionsIntegrating mental health care into PrEP programs is an important step but it is not sufficient to achieve substantial reductions in HIV incidence. Substantial declines require broader engagement in both PrEP and ART, with a coordinated approach that addresses mental health alongside these HIV prevention strategies.

Indexed as

HIV InfectionsHomosexuality, MaleMental Health ServicesPre-Exposure ProphylaxisAdultBisexualityHumansIncidenceMaleMental HealthSocial StigmaUnited StatesDepressionIntegrated approach to HIV eliminationMental healthNetwork modelsPrEP engagementSexual stigma

Identifiers

PMID42458454
PMCPMC13660062

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