BibTex format
@article{Stone:2025:10.1016/s2352-3018(25)00192-4,
author = {Stone, J and Mutai, KK and Artenie, A and Silhol, R and Boily, M-C and Ratevosian, J and Beyrer, C and Vickerman, P},
doi = {10.1016/s2352-3018(25)00192-4},
journal = {The Lancet HIV},
pages = {e712--e721},
title = {The impact of cuts in the US President's Emergency Plan for AIDS Relief funding for HIV pre-exposure prophylaxis in sub-Saharan Africa: a modelling study},
url = {http://dx.doi.org/10.1016/s2352-3018(25)00192-4},
volume = {12},
year = {2025}
}
RIS format (EndNote, RefMan)
TY - JOUR
AB - BackgroundIn January, 2025, the US Government issued a directive, pausing all foreign aid programmes. This directive included a 90-day pausing of all US President's Emergency Plan for AIDS Relief (PEPFAR) funding for HIV oral pre-exposure prophylaxis (PrEP) except for pregnant and breastfeeding women, with a return to funding for PrEP looking increasingly unlikely. We aimed to estimate the impact of a funding pause for PrEP on HIV infections in sub-Saharan Africa.MethodsIn this mathematical modelling study, we developed a static HIV transmission model incorporating PrEP, parameterised with estimates of population size, HIV prevalence and incidence, and PrEP effectiveness for different subpopulations (including key populations) in each PEPFAR-funded sub-Saharan African country. Key populations were men who have sex with men, female sex workers, transgender women, and people who inject drugs. We used PEPFAR reporting on numbers of people in different subpopulations returning for oral PrEP for each country in July to September, 2024, as the estimated number using oral PrEP provided by PEPFAR. For each country and subpopulation, we modelled the relative and absolute increase in new primary HIV infections resulting from removing this funded PrEP for a year and the number of secondary infections that could result from these primary infections during the next 5 years.FindingsTowards the end of 2024, 719384 individuals who were not breastfeeding or pregnant, including 205868 people from key populations, received PEPFAR-funded PrEP across 28 sub-Saharan African countries. The estimated proportion of HIV-negative key population individuals receiving PEPFAR-funded PrEP (ie, the coverage) ranged from 2·6% (95% uncertainty interval 2·0–3·4) in people who inject drugs to 5·0% (4·5–5·9) in female sex workers. Estimated coverage among non-key population men was less than 0·1% (<0·1 to <0·1) and in wo
AU - Stone,J
AU - Mutai,KK
AU - Artenie,A
AU - Silhol,R
AU - Boily,M-C
AU - Ratevosian,J
AU - Beyrer,C
AU - Vickerman,P
DO - 10.1016/s2352-3018(25)00192-4
EP - 721
PY - 2025///
SN - 2352-3018
SP - 712
TI - The impact of cuts in the US President's Emergency Plan for AIDS Relief funding for HIV pre-exposure prophylaxis in sub-Saharan Africa: a modelling study
T2 - The Lancet HIV
UR - http://dx.doi.org/10.1016/s2352-3018(25)00192-4
UR - https://doi.org/10.1016/s2352-3018(25)00192-4
VL - 12
ER -