Annals of Internal Medicine
April 17, 2012; 156 (8)
The Cost-Effectiveness of Preexposure Prophylaxis for HIV Prevention in the United States in Men Who Have Sex With Men
Jessie L. Juusola, Margaret L. Brandeau, Douglas K. Owens, and Eran Bendavid
Ann Intern Med April 17, 2012 156:541-550;
Preexposure chemoprophylaxis (PrEP) with antiretroviral drugs significantly reduces the risk for HIV infection in HIV-negative men who have sex with men (MSM), but its cost-effectiveness is uncertain. In a dynamic model of HIV transmission and progression, a strategy that targeted PrEP to the 20% of MSM considered to be at highest risk for HIV prevented twice as many infections over the long term, and at better economic value, than one that provided PrEP to 20% of all HIV-negative MSM. Targeted PreP could have a substantial impact on the U.S. HIV epidemic at an acceptable cost.