Optimising HIV pre-exposure prophylaxis and testing strategies in men who have sex with men in Australia, Thailand, and China: a modelling study and cost-effectiveness analysis

Zhao, Rui; Fairley, Christopher K; Cook, Alex R; Phanuphak, Nittaya; He, Shiyi; Tieosapjaroen, Warittha; Chow, Eric P F; Phillips, Tiffany R; Jin Tan, Rayner Kay; Wei, Yuhang; Shen, Mingwang; Zhuang, Guihua; Ong, Jason J; Zhang, Lei

doi:10.1016/s2214-109x(23)00536-3

Cited by 9 publications

(1 citation statement)

References 55 publications

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“…Even with regulatory approval, manufacturing scale up and production by generic manufacturers, price will remain an impediment to new long-acting PrEP products. The price of new products, such as CAB-LA, will need to be low to be considered cost-effective, 16 and modelled prices may be too low to be acceptable to manufacturers. The Medicines Patent Pool mechanism, although beneficial to lower-to-middle income countries, does not apply to all nations.…”

Section: Pharmacokinetic Properties and Drugdrug Interactionsmentioning

confidence: 99%

Improving preparedness for introducing and scaling up long-acting HIV pre-exposure prophylaxis in Asia

Bavinton,

Schmidt,

Mills

et al. 2024

Sex. Health

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Long-acting injectable PrEP, particularly cabotegravir (CAB-LA), has the potential to enhance HIV prevention in Asia, and was the topic of a roundtable held in Singapore in June 2023. Despite proven efficacy, CAB-LA’s impact in Asia is hindered by regulatory, manufacturing, and cost barriers. There is an urgent need to address these challenges to expedite CAB-LA’s introduction and scale-up, including collaborative research, streamlined regulatory processes, and increased manufacturing capacity. We call for better preparedness in long-acting PrEP in research and implementation science, product licensing and accessibility, and capacity readiness for scale-up, to meet the significant demand among key populations in Asia.

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Section: Pharmacokinetic Properties and Drugdrug Interactionsmentioning

confidence: 99%

Improving preparedness for introducing and scaling up long-acting HIV pre-exposure prophylaxis in Asia

Bavinton,

Schmidt,

Mills

et al. 2024

Sex. Health

Self Cite

View full text Add to dashboard Cite

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HPV vaccination is highly effective and cost‐effective for cervical cancer prevention in women living with HIV in China: A cost‐effectiveness analysis

Liu,

Zou,

Shen

et al. 2024

Intl Journal of Cancer

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The presence of human immunodeficiency virus (HIV) infection increases the risk of acquiring human papillomavirus (HPV) infection and developing HPV‐related adversities. We aimed to estimate the cost‐effectiveness of HPV vaccination for women living with HIV in a Chinese setting. A decision‐analysis Markov model was developed to estimate the cost‐effectiveness of 36 HPV vaccination strategies for women living with HIV aged 18–45 years, from the healthcare system perspective. With the status quo, not vaccinating women living with HIV would lead to 51.99% (51,985/100,000) HIV‐related deaths; 35.10% (35,098/100,000) would develop genital warts, 0.36% (355/100,000) develop cervical cancer, and among which 63.66% (226/355) die from cervical cancer over their lifetime (1,601,457 person‐years). With a willingness to pay (WTP) threshold of three times gross domestic product (GDP), Gardasil 4 vaccination for all women living with HIV aged 18–45 years was the most cost‐effective strategy (ICER = US $32,766/QALY gained). This strategy would reduce genital warts by 35.52% (12,467/35,098), cervical cancers by 12.96% (46/355), and cervical cancer deaths by 12.39% (28/226) over the lifetime of the cohort. If the future domestic Cecolin 9 vaccine is priced at 60% of Gardasil 9, vaccinating all women living with HIV aged 18–45 years with Cecolin 9 would be the most cost‐effective strategy (ICER = US $30,493/QALY gained). Improving adherence to antiretroviral therapy for HIV may substantially improve the cost‐effectiveness of both Gardasil 4 and Cecolin 9 vaccination.

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Examining the Effects of PrEP Use on Sexual Behaviors and Sexually Transmitted Infections Among Chinese Men who have Sex with Men: A Cross-Sectional Study

She,

Lu,

Zhao

et al. 2024

AIDS Behav

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Men who have sex with men (MSM) is a high-risk population for HIV and sexually transmitted infections (STIs). Pre-exposure prophylaxis (PrEP) is effective in HIV prevention. This study aims to examine the differences in sexual behaviors, STI prevalence and HIV/STI testing across subgroups of MSM with various PrEP use. Data were collected via a cross-sectional survey in an MSM community in Xi’an, Shaanxi, from 2022.01 to 2022.09. Participants were categorized as ‘PrEP-naïve and unwilling to use’, ‘PrEP-naïve but willing to use’, and ‘current or former PrEP users’. Shannon index was used to assess sexual act diversity and multivariate logistic regression analyzed factors associated with PrEP use. Of the 1,131 MSM participants, 23.52% were PrEP-naïve and unwilling, 64.98% were PrEP-naïve but willing, and 11.49% were current or former PrEP users. The PrEP-naïve but willing group had the highest recent STI testing rates at 73.06% and showed greater sexual act diversity (Shannon index 1.61). This group also had the highest syphilis rates (7.49% vs. 6.47% and2.54%, p < 0.01). Younger age (18–30: OR = 0.39 (0.18–0.85); 31–40: OR = 0.43 (0.20–0.96)) and lower education (high school/vocational: OR = 0.15 (0.04–0.58); associate degree: OR = 0.21 (0.06–0.71)) were factors that negatively influenced PrEP use. Current or former PrEP users had the highest oropharyngeal gonorrhea (14.39% vs. 9.68% and 5.80%, p < 0.01) and overall gonorrhea rates (20.86% vs. 17.17% and 8.37%, p < 0.001). ‘PrEP-naïve but willing’ participants consistently demonstrated high-risk sexual behavior, increased STI testing, and more diverse sexual acts, whereas PrEP users had the highest STI prevalence.

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Optimising HIV pre-exposure prophylaxis and testing strategies in men who have sex with men in Australia, Thailand, and China: a modelling study and cost-effectiveness analysis

Cited by 9 publications

References 55 publications

Improving preparedness for introducing and scaling up long-acting HIV pre-exposure prophylaxis in Asia

Improving preparedness for introducing and scaling up long-acting HIV pre-exposure prophylaxis in Asia

HPV vaccination is highly effective and cost‐effective for cervical cancer prevention in women living with HIV in China: A cost‐effectiveness analysis

Examining the Effects of PrEP Use on Sexual Behaviors and Sexually Transmitted Infections Among Chinese Men who have Sex with Men: A Cross-Sectional Study

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