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The Impact of Pre-exposure Prophylaxis for Human Immunodeficiency Virus on Gonorrhea Prevalence.
Bull Math Biol. 2020 Jul 01; 82(7):85.BM

Abstract

Pre-exposure prophylaxis (PrEP) has been shown to be highly effective in reducing the risk of HIV infection in gay and bisexual men who have sex with men (GbMSM). However, PrEP does not protect against other sexually transmitted infections (STIs). In some populations, PrEP has also led to riskier behavior such as reduced condom usage, with the result that the prevalence of bacterial STIs like gonorrhea has increased. Here, we develop a compartmental model of the transmission of HIV and gonorrhea and the impacts of PrEP, condom usage, STI testing frequency and potential changes in sexual risk behavior stemming from the introduction of PrEP in a population of GbMSM. We find that introducing PrEP causes an increase in gonorrhea prevalence for a wide range of parameter values, including at the currently recommended frequency of STI testing once every three months for individuals on PrEP. Moreover, the model predicts that a higher STI testing frequency alone is not enough to prevent a rise in gonorrhea prevalence, unless the testing frequency is increased to impractical levels. However, testing every 2 months in combination with a 10-25 % reduction in risky behavior by individuals on PrEP would maintain gonorrhea prevalence at pre-PrEP levels. The results emphasize that programs making PrEP more available should be accompanied by efforts to support condom usage and frequent STI testing, in order to avoid an increase in the prevalence of gonorrhea and other bacterial STIs.

Authors+Show Affiliations

Department of Applied Mathematics, University of Waterloo, 200 University Ave West, Waterloo, ON, N2L 3G1, Canada.Department of Applied Mathematics, University of Waterloo, 200 University Ave West, Waterloo, ON, N2L 3G1, Canada. cbauch@uwaterloo.ca.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32613297

Citation

Pharaon, Joe, and Chris T. Bauch. "The Impact of Pre-exposure Prophylaxis for Human Immunodeficiency Virus On Gonorrhea Prevalence." Bulletin of Mathematical Biology, vol. 82, no. 7, 2020, p. 85.
Pharaon J, Bauch CT. The Impact of Pre-exposure Prophylaxis for Human Immunodeficiency Virus on Gonorrhea Prevalence. Bull Math Biol. 2020;82(7):85.
Pharaon, J., & Bauch, C. T. (2020). The Impact of Pre-exposure Prophylaxis for Human Immunodeficiency Virus on Gonorrhea Prevalence. Bulletin of Mathematical Biology, 82(7), 85. https://doi.org/10.1007/s11538-020-00762-7
Pharaon J, Bauch CT. The Impact of Pre-exposure Prophylaxis for Human Immunodeficiency Virus On Gonorrhea Prevalence. Bull Math Biol. 2020 Jul 1;82(7):85. PubMed PMID: 32613297.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The Impact of Pre-exposure Prophylaxis for Human Immunodeficiency Virus on Gonorrhea Prevalence. AU - Pharaon,Joe, AU - Bauch,Chris T, Y1 - 2020/07/01/ PY - 2019/08/20/received PY - 2020/06/04/accepted PY - 2020/7/3/entrez KW - Compartmental model KW - Gonorrhea KW - HIV KW - Infectious disease epidemiology KW - Mathematical model KW - Prophylaxis SP - 85 EP - 85 JF - Bulletin of mathematical biology JO - Bull. Math. Biol. VL - 82 IS - 7 N2 - Pre-exposure prophylaxis (PrEP) has been shown to be highly effective in reducing the risk of HIV infection in gay and bisexual men who have sex with men (GbMSM). However, PrEP does not protect against other sexually transmitted infections (STIs). In some populations, PrEP has also led to riskier behavior such as reduced condom usage, with the result that the prevalence of bacterial STIs like gonorrhea has increased. Here, we develop a compartmental model of the transmission of HIV and gonorrhea and the impacts of PrEP, condom usage, STI testing frequency and potential changes in sexual risk behavior stemming from the introduction of PrEP in a population of GbMSM. We find that introducing PrEP causes an increase in gonorrhea prevalence for a wide range of parameter values, including at the currently recommended frequency of STI testing once every three months for individuals on PrEP. Moreover, the model predicts that a higher STI testing frequency alone is not enough to prevent a rise in gonorrhea prevalence, unless the testing frequency is increased to impractical levels. However, testing every 2 months in combination with a 10-25 % reduction in risky behavior by individuals on PrEP would maintain gonorrhea prevalence at pre-PrEP levels. The results emphasize that programs making PrEP more available should be accompanied by efforts to support condom usage and frequent STI testing, in order to avoid an increase in the prevalence of gonorrhea and other bacterial STIs. SN - 1522-9602 UR - https://www.unboundmedicine.com/medline/citation/32613297/The_Impact_of_Pre-exposure_Prophylaxis_for_Human_Immunodeficiency_Virus_on_Gonorrhea_Prevalence L2 - https://dx.doi.org/10.1007/s11538-020-00762-7 DB - PRIME DP - Unbound Medicine ER -
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