title: Impact of Tenofovir gel as a PrEP on HIV infection: a mathematical model.
abstract: Pre-exposure prophylaxis (PrEP) has been considered as one of the promising interventions for HIV infection as experiments on various groups and sites have reported its significant effectiveness. This study evaluates the effectiveness of Tenofovir gel, one of the widely used PrEPs for women, through a mathematical model. Our model has excellent agreement with the experimental data on the use of Tenofovir gel as a PrEP in South African women. Using our model, we estimate both male-to-female and female-to-male transmission rates with and without Tenofovir gel protection. Through these estimates we demonstrate that the use of Tenofovir gel as a PrEP can significantly reduce the reproduction numbers, new infections, and HIV prevalence in South Africa. Our results further show that the effectiveness of Tenofovir gel largely depends on the level of adherence to the gel and the proportion of women under gel coverage. Even though Tenofovir gel alone may not be able to eradicate the disease as indicated by our estimates of the reproduction numbers, together with other interventions, such as condom use, it can serve as a strong weapon to fight against HIV epidemics.
authors.affiliation: Department of Applied Mathematics, University of Western Ontario, London, Ontario, Canada N6A 5B7.
authors.forename: S M Ashrafur
authors.initials: SM
authors.lastname: Rahman
authors.affiliation: Department of Mathematics and Statistics, University of Missouri - Kansas City, MO 64110 USA. Electronic address: vaidyan@umkc.edu.
authors.forename: Naveen K
authors.initials: NK
authors.lastname: Vaidya
authors.affiliation: Department of Applied Mathematics, University of Western Ontario, London, Ontario, Canada N6A 5B7.
authors.forename: Xingfu
authors.initials: X
authors.lastname: Zou
mesh_terms: D000225:Adenine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D005782:Gels; D015658:HIV Infections / Q000517:prevention & control*; D006801:Humans; D008962:Models, Theoretical; D063065:Organophosphonates / Q000008:administration & dosage / Q000627:therapeutic use*; D018894:Reverse Transcriptase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D013019:South Africa; D000068698:Tenofovir
chemical_list: D005782:Gels; D063065:Organophosphonates; D018894:Reverse Transcriptase Inhibitors; D000068698:Tenofovir; D000225:Adenine
keywords: HIV; Mathematical model; PrEP; Tenofovir gel; Transmission rate