BibTex format
@article{Leng:2025:10.1016/S2214-109X(25)00098-1,
author = {Leng, T and Kessou, L and Heitner, J and Guedou, FA and Behanzin, L and Olodo, M and Diabate, S and Silhol, R and Dimitrov, D and Vickerman, P and Alary, M and Boily, MC and Mitchell, KM},
doi = {10.1016/S2214-109X(25)00098-1},
journal = {The Lancet Global Health},
pages = {E1111--E1121},
title = {Potential impact and cost-effectiveness of oral HIV pre-exposure prophylaxis for men who have sex with men in Cotonou, Benin: a mathematical modelling study},
url = {http://dx.doi.org/10.1016/S2214-109X(25)00098-1},
volume = {13},
year = {2025}
}
RIS format (EndNote, RefMan)
TY - JOUR
AB - Background:Oral HIV pre-exposure prophylaxis (PrEP) can effectively reduce HIV incidence. A 2020–21 demonstration project assessed the feasibility and health outcomes of offering oral PrEP to men who have sex with men (MSM) in Cotonou, Benin. We evaluated the epidemiological impact and cost-effectiveness of this project and the potential scale-up of oral HIV PrEP for MSM in Cotonou.Methods:We calibrated an HIV transmission-dynamic model structured by age and risk within a Bayesian framework to MSM-specific HIV prevalence and treatment data, parameterised with project behavioural and cost (including PrEP drug, implementation, and HIV care costs) data. We estimated the impact and cost-effectiveness of the 2020–21 Cotonou demonstration project (PrEP coverage, 5–10% of all MSM who are not living with HIV in Grand Cotonou; and adherence, 13–21% taking at least four of seven required doses [ie, at least four doses per week for daily users and at least four of seven expected doses given reported sexual activity for on-demand users]) and of its potential scale-up over 5 years (from 2022 to 2027), reaching 30% coverage of MSM in Grand Cotonou and with demonstration project adherence levels. We additionally modelled ideal PrEP adherence (100% taking at least four of seven required doses). We estimated the percentage of cumulative new HIV infections averted among participating MSM over 1 year and among all MSM in Grand Cotonou and their female partners over 20 years, and cost-effectiveness as cost per disability-adjusted life-year (DALY) averted over 20 years. Costs and DALYs were discounted 3% annually.Findings:We found that the demonstration project averted an estimated 21·5% (95% uncertainty interval 16·6 to 26·2) of HIV infections among participants over 1 year. With ideal adherence, cases that would be averted increased to 95·2% (90·8 to 98·8). A 5-year PrEP scale-up could avert 3·2% (1·6 to 4
AU - Leng,T
AU - Kessou,L
AU - Heitner,J
AU - Guedou,FA
AU - Behanzin,L
AU - Olodo,M
AU - Diabate,S
AU - Silhol,R
AU - Dimitrov,D
AU - Vickerman,P
AU - Alary,M
AU - Boily,MC
AU - Mitchell,KM
DO - 10.1016/S2214-109X(25)00098-1
EP - 1121
PY - 2025///
SN - 2214-109X
SP - 1111
TI - Potential impact and cost-effectiveness of oral HIV pre-exposure prophylaxis for men who have sex with men in Cotonou, Benin: a mathematical modelling study
T2 - The Lancet Global Health
UR - http://dx.doi.org/10.1016/S2214-109X(25)00098-1
VL - 13
ER -