Please use this identifier to cite or link to this item:
https://hdl.handle.net/1/1336
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DC Field | Value | Language |
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dc.contributor.author | Allen, Debra M | - |
dc.contributor.author | Smith, David J | - |
dc.contributor.other | Grulich, A.E. | - |
dc.contributor.other | Guy, R. | - |
dc.contributor.other | Amin, J. | - |
dc.contributor.other | Jin, F. | - |
dc.contributor.other | Selvey, C. | - |
dc.contributor.other | Holden, J. | - |
dc.contributor.other | Schmidt, H.A. | - |
dc.contributor.other | Zablotska, I. | - |
dc.contributor.other | Price, K. | - |
dc.contributor.other | Whittaker, B. | - |
dc.contributor.other | Chant, K. | - |
dc.contributor.other | Cooper, C. | - |
dc.contributor.other | McGill, S. | - |
dc.contributor.other | Telfer, B. | - |
dc.contributor.other | Yeung, B. | - |
dc.contributor.other | Levitt, G. | - |
dc.contributor.other | Ogilvie, E.E. | - |
dc.contributor.other | Dharan, N.J. | - |
dc.contributor.other | Hammoud, M.A. | - |
dc.contributor.other | Vaccher, S. | - |
dc.contributor.other | Watchirs-Smith, L. | - |
dc.contributor.other | McNulty, A. | - |
dc.contributor.other | Baker, D. | - |
dc.contributor.other | Bloch, M. | - |
dc.contributor.other | Bopage, R.I. | - |
dc.contributor.other | Brown, K. | - |
dc.contributor.other | Carr, A. | - |
dc.contributor.other | Carmody, C.J. | - |
dc.contributor.other | Collins, K.L. | - |
dc.contributor.other | Finlayson, R. | - |
dc.contributor.other | Foster, R. | - |
dc.contributor.other | Jackson, E.Y. | - |
dc.contributor.other | Lewis, D.A. | - |
dc.contributor.other | Lusk, J. | - |
dc.contributor.other | O'Connor, C.C. | - |
dc.contributor.other | Ryder, N. | - |
dc.contributor.other | Vlahakis, E. | - |
dc.contributor.other | Read, P. | - |
dc.contributor.other | Cooper, D.A. | - |
dc.date.accessioned | 2019-04-05T00:32:36Z | en |
dc.date.available | 2019-04-05T00:32:36Z | en |
dc.date.issued | 2018-11 | - |
dc.identifier.citation | 5(11):e629-e637 | en |
dc.identifier.issn | 2352-3018 | en |
dc.identifier.uri | https://elibrary.cclhd.health.nsw.gov.au/cclhdjspui/handle/1/1336 | en |
dc.description.abstract | BACKGROUND: HIV pre-exposure prophylaxis (PrEP) is highly effective in men who have sex with men (MSM) at the individual level, but data on population-level impact are lacking. We examined whether rapid, targeted, and high-coverage roll-out of PrEP in an MSM epidemic would reduce HIV incidence in the cohort prescribed PrEP and state-wide in Australia's most populous state, New South Wales. METHODS: The Expanded PrEP Implementation in Communities-New South Wales (EPIC-NSW) study is an implementation cohort study of daily co-formulated tenofovir disoproxil fumarate and emtricitabine as HIV PrEP. We recruited high-risk gay men in a New South Wales-wide network of 21 clinics. We report protocol-specified co-primary outcomes at 12 months after recruitment of the first 3700 participants: within-cohort HIV incidence; and change in population HIV diagnoses in New South Wales between the 12-month periods before and after PrEP roll-out. The study is registered with ClinicalTrials.gov, number NCT02870790. FINDINGS: We recruited 3700 participants in the 8 months between March 1, 2016, and Oct 31, 2016. 3676 (99%) were men, 3534 (96%) identified as gay, and 149 (4%) as bisexual. Median age was 36 years (IQR 30-45 years). Overall, 3069 (83%) participants attended a visit at 12 months or later. Over 4100 person-years, two men became infected with HIV (incidence 0.048 per 100 person-years, 95% CI 0.012-0.195). Both had been non-adherent to PrEP. HIV diagnoses in MSM in New South Wales declined from 295 in the 12 months before PrEP roll-out to 221 in the 12 months after (relative risk reduction [RRR] 25.1%, 95% CI 10.5-37.4). There was a decline both in recent HIV infections (from 149 to 102, RRR 31.5%, 95% CI 11.3 to 47.3) and in other HIV diagnoses (from 146 to 119, RRR 18.5%, 95% CI -4.5 to 36.6). INTERPRETATION: PrEP implementation was associated with a rapid decline in HIV diagnoses in the state of New South Wales, which was greatest for recent infections. As part of a combination prevention approach, rapid, targeted, high-coverage PrEP implementation is effective to reduce new HIV infections at the population level. FUNDING: New South Wales Ministry of Health, Gilead Sciences. | en |
dc.description.sponsorship | Sexual Health | en |
dc.subject | Public Health | en |
dc.subject | Drug Therapy | en |
dc.title | Population-level effectiveness of rapid, targeted, high-coverage roll-out of HIV pre-exposure prophylaxis in men who have sex with men: the EPIC-NSW prospective cohort study | en |
dc.type | Journal Article | en |
dc.identifier.doi | 10.1016/s2352-3018(18)30215-7 | en |
dc.description.pubmeduri | https://pubmed.ncbi.nlm.nih.gov/30343026/ | en |
dc.description.affiliates | Central Coast Local Health District | en |
dc.description.affiliates | Gosford Hospital | en |
dc.identifier.journaltitle | The Lancet HIV | en |
dc.originaltype | Text | en |
item.fulltext | No Fulltext | - |
item.grantfulltext | none | - |
item.openairecristype | http://purl.org/coar/resource_type/c_18cf | - |
item.openairetype | Journal Article | - |
item.cerifentitytype | Publications | - |
Appears in Collections: | Health Service Research |
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