Modeling the joint effects of adolescent and adult PrEP for sexual minority males in the United States

Hamilton, Deven T.; Rosenberg, Eli S.; Jenness, Samuel M.; Sullivan, Patrick S.; Wang, Li Yan; Dunville, Richard; Barrios, Lisa C.; Aslam, Maria; Goodreau, Steven M.

doi:10.1371/journal.pone.0217315

Cited by 10 publications

(12 citation statements)

References 42 publications

(138 reference statements)

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“…In particular, epidemic models that explicitly account for the observed variation are likely to provide the most accurate impact of these behaviors. For example, epidemic models are well positioned to estimate the impact of this temporal variation on intervention effectiveness (Hamilton et al, 2019; Luo et al, 2018), optimizing prevention policies (Jenness et al, 2016; Kelly et al, 2018), helping efficiently target resources (Elion et al, 2019; Goodreau et al, 2018), and estimating the cost-effectiveness of prevention strategies (Harmon et al, 2016; L. Zhang et al, 2019). Given the foundational work that has already examined the impact of episodic variation in contact rates on HIV (Henry & Koopman, 2015; Romero-Severson et al, 2015; X.…”

Section: Discussionmentioning

confidence: 99%

Temporal variation in one-time partnership rates among young men who have sex with men and transgender women

Janulis¹,

Goodreau

Birkett³

et al. 2020

Preprint

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Background: Volatility in sexual contact rates has been recognized as an important factor influencing HIV transmission dynamics. One-time partnerships may be particularly important given the potential to quickly accumulate large number of contacts. Yet, empirical data documenting individual variation in contact rates remains rare. This study provides much needed data on temporal variation in one-time partners to better understand behavioral dynamics and improve the accuracy of transmission models. Methods: Data for this study from a longitudinal cohort study of young men who have sex with men (MSM) and transgender women in Chicago. Participants provided sexual network data every 6-months for 2 years. A series of random effects models examined variation in one-time partnership rates and disaggregated within and between associations of exposure variables. Exposure variables included prior number of one-time partners, number of casual partners, and having a main partner. Results: Results indicated substantial between and within person variation in one-time partners. Casual partnerships were positively associated and main partnerships negatively association with one-time partnership rates. There remained a small positive association between prior one-time partnerships and the current number of one-time partnerships. Conclusions: Despite the preponderance of a low number of one-time partners, substantial variation in one-time partnership rates exists among young MSM and transgender women. Accordingly, focusing on high contact rate individuals alone may be insufficient to identify periods of highest risk. Future studies should utilize these estimates to more accurately model how volatility impacts HIV transmission and better understand how this variation influences intervention effectiveness.

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Section: Discussionmentioning

confidence: 99%

Temporal variation in one-time partnership rates among young men who have sex with men and transgender women

Janulis¹,

Goodreau

Birkett³

et al. 2020

Preprint

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“…We used a previously described stochastic dynamic network model comprising ~54,000 adolescent and adult MSM ages 13–39 [ 17 ]. Similar to previous analyses [ 17 ], we modeled sexual relationship formation and dissolution; sexual behavior within partnerships; HIV testing; initiation, adherence and discontinuation of both ART treatment and PrEP; transmission; intrahost viral dynamics, including viral suppression but excluding drug resistance; and demographic change. The model was implemented using the EpiModel platform [ 18 ].…”

Section: Methodsmentioning

confidence: 99%

Modeling the Impact of PrEP Programs for Adolescent Sexual Minority Males Based on Empirical Estimates for the PrEP Continuum of Care

Hamilton

Rosenberg

Sullivan

et al. 2021

Journal of Adolescent Health

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Purpose: Pre-exposure prophylaxis (PrEP)—an effective and safe intervention to prevent HIV transmission—was recently approved by the Food and Drug Administration for use by adolescents. Informed by studies of sexual behavior and PrEP adherence, retention, and promotion, we model the potential impact of PrEP use among at-risk adolescent sexual minority males. Methods: We simulate an HIV epidemic among men who have sex with men (MSM) aged 13–39. We assume adult MSM ages 19–39 have had PrEP available for 3 years with 20% coverage among eligible MSM based on the Centers for Disease Control and Prevention guidelines. PrEP interventions for ages 16–18 are then simulated using adherence and retention profiles drawn from the ATN113 and Enhancing Preexposure Prophylaxis in Community studies across a range of uptake parameters (10%–100%). Partnerships across age groups were modeled using parameterizations from the RADAR study. We compare the percent of incident infections averted (impact), person-years on PrEP per infection averted (efficiency), and changes in prevalence over 10 years. Results: As compared to no PrEP use, baseline PrEP adherence and retention among adolescent sexual minority males drawn from the ATN113 and Enhancing Preexposure Prophylaxis in Community studies averted from 2.8% to 41.0% of HIV infections depending on the fraction of eligible adolescent sexual minority males that initiated PrEP at their annual health-care visit. Improved adherence and retention achieved with an array of focused interventions from real-world settings increased the percent of infections averted by as much as 26%–70%. Conclusions: Empirically demonstrated improvements in the PrEP continuum of care in response to existing interventions can substantially reduce incident HIV infections among adolescent sexual minority males.

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“…We used approximate Bayesian computation to estimate values for 3 calibration parameters yielding simulated epidemics matching 2 HIV prevalence targets: 7% among sexually active 18-year-old ASMM 37s and 28.3% among adult MSM 38s for comparability with previous models examining HIV prevention among ASMM. [19][20][21][22] The model was implemented using EpiModel. 19,39s,40s Specific model features and parameterization for condom use depended on outcomes of the empirical analyses and are described under Results; a preestablished decision rule required disaggregating condom use probabilities in the model for variables significantly predicting condom use in 2 or more of 3 data sets.…”

Section: Epidemic Modelingmentioning

confidence: 99%

Effects of Condom Use on Human Immunodeficiency Virus Transmission Among Adolescent Sexual Minority Males in the United States: A Mixed Epidemiology and Epidemic Modeling Study

Katz¹,

Hamilton

Rosenthal

et al. 2021

Sexual Trans Dis

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Background:We examined condom use patterns and potential populationlevel effects of a hypothetical condom intervention on human immunodeficiency virus (HIV) transmission among adolescent sexual minority males (ASMM).Methods: Using 3 data sets: national Youth Risk Behavior Survey 2015 to 2017 (YRBS-National), local YRBS data from 8 jurisdictions with sex of partner questions from 2011 to 2017 (YRBS-Trends), and American Men's Internet Survey (AMIS) 2014 to 2017, we assessed associations of condom use with year, age, and race/ethnicity among sexually active ASMM. Using a stochastic agent-based network epidemic model, structured and parameterized based on the above analyses, we calculated the percent of HIV infections averted over 10 years among ASMM ages 13 to 18 years by an intervention that increased condom use by 37% for 5 years and was delivered to 62% of ASMM at age 14 years. Results:In YRBS, 51.8% (95% confidence interval [CI], 41.3-62.3%) and 37.9% (95% CI, 32.7-42.3%) reported condom use at last sexual intercourse in national and trend data sets, respectively. In AMIS, 47.3% (95% CI, 44.6-49.9%) reported condom use at last anal sex with a male partner. Temporal trends were not observed in any data set (P > 0.1). Condom use varied significantly by age in YRBS-National (P < 0.0001) and YRBS-Trends (P = 0.032) with 13-to 15-year-olds reporting the lowest use in both; age differences were not significant in AMIS (P = 0.919). Our hypothetical intervention averted a mean of 9.0% (95% simulation interval, −5.4% to 21.2%) of infections among ASMM. Conclusions:Condom use among ASMM is low and appears to have remained stable during 2011 to 2017. Modeling suggests that condom use increases, consistent with previous interventions, have potential to avert 1 in 11 new HIV infections among ASMM.

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Modeling the joint effects of adolescent and adult PrEP for sexual minority males in the United States

Cited by 10 publications

References 42 publications

Temporal variation in one-time partnership rates among young men who have sex with men and transgender women

Temporal variation in one-time partnership rates among young men who have sex with men and transgender women

Modeling the Impact of PrEP Programs for Adolescent Sexual Minority Males Based on Empirical Estimates for the PrEP Continuum of Care

Effects of Condom Use on Human Immunodeficiency Virus Transmission Among Adolescent Sexual Minority Males in the United States: A Mixed Epidemiology and Epidemic Modeling Study

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