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Generic daily HIV prevention pill for young men who have sex with men could save lives and money – study

Over 10 years, the generic PrEP strategy would reduce new HIV acquisitions from 37% to 30% and decrease costs per person, compared to annual screening.

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In the US alone, about one in five new HIV diagnoses occur among young people aged from 13 to 24 years. Particularly, young men who have sex with men (YMSM) account for 81% of new diagnoses in this age group in 2019. There’s a new tool that can help deal with this – i.e. when taken daily as prescribed, oral HIV pre-exposure prophylaxis (PrEP) reduces the risk of sexually acquiring HIV by about 99%. And yet compared to older men who have sex with men, YMSM are less likely to start PrEP and tend to have more challenges adhering to PrEP and remaining in care.

A study – “Daily Oral Human Immunodeficiency Virus (HIV) Pre-exposure Prophylaxis Among Young Men Who Have Sex With Men in the United States: Cost-saving at Generic Drug Price” by Alyssa K. Amick, et al that appeared in Clinical Infectious Diseases – looked at a way to understand how tenofovir-based daily PrEP would compare to current CDC-recommended annual HIV screening in terms of clinical benefits and costs among US-based YMSM in light of newly available generic PrEP medication and new CDC guidelines for PrEP use.

The 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 daily TDF-FTC among 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). 

The researchers:

  • projected that over 10 years, the generic PrEP strategy would reduce new HIV acquisitions from 37% to 30% and decrease costs by $5,000 per person, compared to annual screening
  • found that PrEP would provide more benefits at lower cost held up across several scenarios, including a range of ART prices, HIV incidence rates, and PrEP retention rates
  • stressed that even if as few as 6% of young men remained in the PrEP program after six years, the strategy would still have benefits over annual screening
  • found that offering generic PrEP in addition to screening every three months was more cost-saving than every-three-month screening alone 

For the researchers, the findings “show us that we would be throwing away both lives and money by failing to implement generic PrEP in this population. Policies that create barriers to PrEP access for this population… aren’t justifiable on clinical or economic grounds.”


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