13 Mar PLOS Medicine on PrEP
An analysis led by Gabriela Gomez, AIGHD, AMC Department of Global Health
published March 12
Preventing HIV infection with antiretroviral drugs in people at risk of HIV exposure is cost-effective
A review of 13 modelling studies, published in this week’s PLOS Medicine led by Gabriela Gomez and Catherine Hankins from the Department of Global Health, Academic Medical Centre, University of Amsterdam/AIGHD, found that pre-exposure prophylaxis (PrEP) is a cost-effective method for preventing HIV in specific populations and epidemic contexts.
The researchers evaluated the impact of PrEP for HIV prevention in different populations (heterosexual couples, men who have sex with men, and people who inject drugs) in different regions and countries, such as southern Africa, Ukraine, the US, and Peru. In every setting, the cost of antiretroviral drugs was an important factor influencing the affordability of effective prevention programmes. Delivery of PrEP to populations at higher risk of HIV exposure emerged as the most cost-effective strategy.
The authors also found that both behavioural changes and adherence to PrEP drug regimens affected programme effectiveness. These findings are in line with those recently published by the investigators of the VOICE trial showing that PrEP has to be taken to be effective.
The results highlight the importance of both the epidemiological setting and the population that is prioritised for PrEP as critical drivers of cost-effectiveness. Context-specific demonstration studies, including comprehensive cost analyses, of different prioritisation and adherence promotion strategies are needed now to ensure that the maximum benefit from the introduction of PrEP is realised within combination HIV prevention programmes.
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