Table 2 Sensitivity analyses on HIV elimination under stochastic modeling

From: A modeling study of pre-exposure prophylaxis to eliminate HIV in Taiwan by 2030

Scenario

HIV elimination with test-and-treat alone

HIV elimination with PrEP

Base scenarioa

No

Yes

Coverage of PrEP decreases to 25%

–

Yes/Nob

Coverage of PrEP increases to 75%

–

Yes

Sexual partners increase to 75/year

No

Yes

Sexual partners decrease to 25/year

Yes

Yes

Acute-stage infectiousness: 3-fold

Yes

Yes

Acute-stage infectiousness: 10-fold

Yes

Yes

Acute-stage infectiousness: 30-fold

No

Yes

Condom usage among PrEP users decreases from 30% to 0%

–

Yes

Adherence to PrEP decreases to 75%

–

Yes

FTC/TDF resistance increases to 10%

–

Yes

  1. HIV elimination is defined by the World Health Organization (WHO) as having an R0 < 1.
  2. PrEP pre-exposure prophylaxis, FTC/TDF emtricitabine/tenofovir.
  3. aThe base scenario involves a mixing level of 50 sexual partners per year and an infectiousness during the acute stage that is 26-fold higher than during the chronic stage. For the test-and-treat strategy, the base scenario includes annual HIV testing and immediate initiation of ART. For the PrEP program, the base scenario assumes a 50% coverage among high-risk men who have sex with men aged 15–44, with an efficacy of 86%, under the status quo test-and-treat strategy (HIV testing every 2.5 years with HIV care continuum). The PrEP program is associated with an increased rate of HIV testing (entry testing and then every 3 months, multiplied by the PrEP coverage rate, assuming 100% compliance with HIV testing).
  4. bDependent on the existence of a PrEP-associated increase in HIV testing. Elimination is not feasible in simulations that do not consider the PrEP-associated increase in HIV testing rate (see Table 1).
Back to article page