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Clin Infect Dis. 2015 Nov 15;61(10):1590-7. doi: 10.1093/cid/civ664. Epub 2015 Aug 13.

Applying a PrEP Continuum of Care for Men Who Have Sex With Men in Atlanta, Georgia.

Author information

1
Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine Department of Epidemiology.
2
Department of Epidemiology.
3
Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia.

Abstract

Reductions in human immunodeficiency virus (HIV) incidence with pre-exposure prophylaxis (PrEP) for men who have sex with men (MSM) will require significant coverage of those at risk. We propose a simplified framework, similar to the HIV care continuum, to achieve protection with PrEP as follows: 1. At-risk MSM; 2. Awareness of and willingness to take PrEP; 3. Access to healthcare; 4. Receiving a prescription; and 5. Adhering to effective PrEP. We evaluated the PrEP care continuum on an Atlanta cohort of MSM and projected how many MSM might achieve protection from HIV. Even with optimistic estimates, few Atlanta MSM (15%) are projected to achieve protection from HIV with PrEP given the significant barriers described. Each continuum step represents an important point for intervention that could substantially increase the overall effectiveness of PrEP. In addition, novel strategies for PrEP delivery are needed to achieve the necessary effectiveness for Atlanta MSM at risk of HIV.

KEYWORDS:

continuum of care; men who have sex with men; pre-exposure prophylaxis

PMID:
26270691
PMCID:
PMC4614414
DOI:
10.1093/cid/civ664
[Indexed for MEDLINE]
Free PMC Article

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