Agent-based computational model of the prevalence of gonococcal infections after the implementation of HIV pre-exposure prophylaxis guidelines

Abstract

Recently, the first comprehensive guidelines were published for pre-exposure prophylaxis (PrEP) for the prevention of HIV infection in populations with substantial risk of infection. Guidelines include a daily regimen of emtricitabine/tenofovir disoproxil fumarate (TDF/FTC) as well as condom usage during sexual activity. The relationship between the TDF/FTC intake regimen and condom usage is not yet fully understood. If men who have sex with men (MSM,) engage in high-risk sexual activities without using condoms when prescribed TDF/FTC they might be at an increased risk for other sexually transmitted diseases (STD). Our study focuses on the possible occurrence of behavioral changes among MSM in the United States over time with regard to condom usage. In particular, we were interested in creating a model of how increased uptake of TDF/FTC might cause a decline in condom usage, causing significant increases in non-HIV STD incidence, using gonococcal infection incidence as a biological endpoint. We used the agent-based modeling software NetLogo, building upon an existing model of HIV infection. We found no significant evidence for increased gonorrhea prevalence due to increased PrEP usage at any level of sample-wide usage, with a range of 0-90% PrEP usage. However, we did find significant evidence for decreased prevalence of HIV, with a maximal effect being reached when 5% to 10% of the MSM population used PrEP. Our findings appear to indicate that attitudes of aversion, within the medical community, toward the promotion of PrEP due to the potential risk of increased STD transmission are unfounded.

Behavioural, not biological, factors drive the HCV epidemic among HIV-positive MSM: HCV and HIV modelling analysis including HCV treatment-as-prevention impact

“…To our knowledge, this is the first modelling analysis of the joint epidemics of HIV and HCV among MSM, although numerous previous analyses have modelled just HIV 17 and some have also modelled other sexually transmitted infections (STI) among MSM. 17,[34][35][36][37] However, existing HIV and STI co-infection models generally considered different questions, focusing primarily on the degree to which STIs contribute to HIV transmission and the possible impact of STI treatment on HIV epidemics. Previous analyses have also modelled the transmission of HIV and HCV among people who inject drugs.…”

Sustainability of religious communities

“…The average couple tendency indicates how much one agent likes becoming a couple, and then, the couples form and break up according to coupling tendency and couple commitment. The likelihood of agent coupling determines the degree of transmission [ 52 ].…”

Estimating Partnership Duration among MSM in Belgium—A Modeling Study

“…Several modeling studies have described the transmission of CT and NG among MSM [ 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 ], which cluster in a few Western countries, mainly from the US [ 9 , 13 , 14 , 19 , 25 , 26 , 27 , 28 , 35 , 36 ] and Australia [ 18 , 22 , 23 , 24 , 32 , 40 , 41 , 42 , 43 ]. In Europe, notable modeling studies have been conducted in the UK [ 31 , …”

“…Several modeling studies have described the transmission of CT and NG among MSM , which cluster in a few Western countries, mainly from the US [9,13,14,19,[25][26][27][28]35,36] and Australia [18,[22][23][24]32,[40][41][42][43]. In Europe, notable modeling studies have been conducted in the UK [31,37,38,45] and The Netherlands [17,29,30,33,39,44], with few papers from France [34], Belgium [8,16] and Switzerland [20,21].…”