Anne Neilan, MD, a physician-scientist within the division of Infectious Diseases at Massachusetts General Hospital is the senior writer of a recently published paper in Clinical Infectious Diseases, Day by day Oral HIV Pre-exposure Prophylaxis Amongst Young Men Who Have Sex With Men in the USA: Cost-Saving at Generic Drug Price.

What query were you investigating?

About one in five latest HIV diagnoses in the USA occur amongst youth ages 13 to 24 years. Young men who’ve sex with men (YMSM) are account for 81% of latest diagnoses on this age group in 2019. When taken every day as prescribed, oral PrEP reduces the danger of sexually acquiring HIV by about 99%. In comparison with older men who’ve sex with men, YMSM are less more likely to start PrEP and are inclined to have more challenges adhering to PrEP and remaining in care.

Our team wanted to know how tenofovir-based every day oral HIV pre-exposure prophylaxis (PrEP) would compare to current CDC-recommended annual HIV screening by way of clinical advantages and costs amongst U.S.-based YMSM in light of newly available generic PrEP medication and latest CDC guidelines for PrEP use.

What methods or approaches did you employ?

Our research team used data from two studies conducted by NICHD’s Adolescent Medicine Trials Network for HIV Interventions. These studies examined the acceptability and feasibility of every day TDF-FTC amongst young men ages 15 to 22 years considered at increased risk of acquiring HIV because they because they engaged in condomless anal sex or had other sexually transmitted infections (STIs).

What were your findings?

The model projected that over 10 years, the generic PrEP strategy would scale back latest HIV acquisitions from 37% to 30% and reduce costs by $5,000 per person, in comparison with annual screening.

The finding that PrEP would supply more advantages at lower cost held up across several scenarios, including a variety of ART prices, HIV incidence rates, and PrEP retention rates.

Even when as few as 6% of young men remained within the PrEP program after six years, the strategy would still have advantages over annual screening.

Our team also found that offering generic PrEP along with screening every three months was more cost-saving than every-three-month screening alone.

What are the clinical implications?

Our findings show us that we could be throwing away each lives and money by failing to implement generic PrEP on this population. Policies that create barriers to PrEP access for this population – equivalent to the recent Braidwood Management versus Becerra case, which overrules ACA-mandated employer-based coverage for HIV PrEP – aren’t justifiable on clinical or economic grounds.

What are the subsequent steps?

Our research team’s next step is to know the worth interventions to enhance access to and adherence to existing and novel HIV prevention strategies in adolescents and young adults within the US and abroad.