Applying a PrEP Continuum of Care for Men Who Have Sex With Men in Atlanta, Georgia.
Reductions in human immunodeficiency virus (HIV) incidence with pre-exposure prophylaxis (PrEP) for men who have sex with men (MSM) will require significant coverage of those at risk. We propose a simplified framework, similar to the HIV care continuum, to achieve protection with PrEP as follows: 1. At-risk MSM; 2. Awareness of and willingness to take PrEP; 3. Access to healthcare; 4. Receiving a prescription; and 5. Adhering to effective PrEP. We evaluated the PrEP care continuum on an Atlanta cohort of MSM and projected how many MSM might achieve protection from HIV. Even with optimistic estimates, few Atlanta MSM (15%) are projected to achieve protection from HIV with PrEP given the significant barriers described. Each continuum step represents an important point for intervention that could substantially increase the overall effectiveness of PrEP. In addition, novel strategies for PrEP delivery are needed to achieve the necessary effectiveness for Atlanta MSM at risk of HIV.
Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine Department of Epidemiology.
Colleen F
CF
Kelley
Department of Epidemiology.
Erin
E
Kahle
Department of Epidemiology.
Aaron
A
Siegler
Department of Epidemiology.
Travis
T
Sanchez
Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia.
Carlos
C
Del Rio
Department of Epidemiology.
Patrick S
PS
Sullivan
Department of Epidemiology.
Eli S
ES
Rosenberg
D018890:Chemoprevention / Q000379:methods*; D003266:Continuity of Patient Care; D005845:Georgia / Q000453:epidemiology; D015658:HIV Infections / Q000453:epidemiology* / Q000517:prevention & control*; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D015233:Models, Statistical; D065129:Pre-Exposure Prophylaxis / Q000379:methods*
continuum of care; men who have sex with men; pre-exposure prophylaxis