The Simulation Study On Epidemiologic And Economic Impact Of Preexposure Prophylaxis For Men Who Have Sex With Men In China

Several studies indicated that HIV preexposure prophylaxis(Pr EP)could substantially reduce the risk of HIV infection.Consequently,our study aim to estimate epidemiologic and economic impact of introducing Pr EP to men who have sex with men(MSM)in China.We developed a dynamic compartmental model to simulate the acquisition and progression of HIV infection among MSM population in China during 2016-2025,and the health outcomes and cost-effectiveness of Pr EP strategy were evaluated under several scenarios.If Pr EP regimen was implemented for 20% of general MSM in China,31,783 new HIV infections(proportion of 21.7% reduction in new infections)would be prevented over the next 10 years(2016-2025),and HIV prevalence would decrease from 9.2% to 8.0% at 2025.Total 293,717 incremental QALYs at a cost of ?553,217/QALY gained compared with status quo.Pr EP scenarios targeting M-C-P(1.5-fold casual partners more than general)MSM and M-S-P(1.5-fold steady partners more than general)MSM would cost ?229,575 and ?103,420 per QALY gained,respectively.Our study found that substantial reduction in new HIV infections and remission in HIV transmission if Pr EP was introduced to MSM population in China.Scenarios using Pr EP in general or M-C-P MSM was proved expensive.While Pr EP program targeting for M-S-P MSM was a cost-effective strategy,and the incremental costeffectiveness ratios(ICERs)would increase as Pr EP program coverage levels increased.