Exploring Projections for HIV Infection with Pre-Exposure Prophylaxis Usage in a High-Risk Population

Abstract

Featured Application: The numerical model may be modified to provide national, state, or local means of monitoring adherence to PrEP protocols, assessing disparities and access to care, and to inform public policy regarding PrEP advocacy. Prevention of type-1 human immunodeficiency virus (HIV) infections has primarily been through condom usage, abstinence, and behavioral and risk awareness programs. Pre-exposure prophylaxis (PrEP) medications became approved for infection prevention in 2012. Mathematical models exploring the projections and impacts of PrEP on the spread of HIV are sparse. This study develops an epidemiological model for type-1 HIV infection accounting for both PrEP and condom usage. We utilized CDC surveillance data on HIV/AIDS statistics to develop a susceptible, infected, AIDS numerical model containing PrEP, condoms, and the combination of both. We explore projections with the percentages of PrEP usage held constant and the impact of average annual sexual partners. We find when 70% of the high-risk population uses PrEP properly with an average of 2 sexual partners per year, the eventual infected percentage drops to about 15%. In contrast, when PrEP is not used correctly and with 4 partners per year the total eventual infected percentage rises to 59%. PrEP can be a highly effective mitigator for the spread of HIV. However, an increased average number of sexual partners per year with improper PrEP usage can minimize the long-term effectiveness of PrEP.