Potential impact of pre-exposure prophylaxis for female sex workers and men who have sex with men in Bangalore, India: a mathematical modelling study

Kate M Mitchell, Holly J Prudden, Reynold Washington, Shajy Isac, Subramanian P Rajaram, Anna M Foss, Fern Terris-Prestholt, Marie-Claude Boily, Peter Vickerman Journal of the International AIDS Society, 2016; JIAS, Volume 19, No.1

In Bangalore, new HIV infections of female sex workers and men who have sex with men continue to occur, despite high condom use. Pre-exposure prophylaxis (PrEP) has high anti-HIV efficacy for men who have sex with men. PrEP demonstration projects are underway amongst Indian female sex workers. This research estimated the impact and efficiency of prioritising PrEP to female sex workers and/or men who have sex with men in Bangalore using a mathematical modelling method. 

The results show that:

  • PrEP could prevent a substantial proportion of infections amongst female sex workers and men who have sex with men in this setting, which could avert more than 4% of infections in the whole Bangalore population over 10 years.
  • Impact and efficiency in the whole population was greater if female sex workers were prioritised.
  • Efficiency increased, but impact decreased, if only female sex workers with lower condom use were given PrEP.
  • Greater impact and efficiency was predicted for the scenario with lower condom use.

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