THE IMPACT OF PRE-EXPOSURE PROPHYLAXIS ON MEN WHO HAVE SEX WITH MEN IN CAMEROON: A MODELING STUDY

Men who have sex with men (MSM) have been consistently burdened by human immunodeficiency virus (HIV) at higher rates than adults in the general population. Cameroon has a large MSM population throughout its major cities. Though PrEP has been shown to reduce infections in MSM populations, it has yet to be introduced in Cameroon. This study uses a mathematical model to simulate population level HIV transmission in Cameroon among MSM. PrEP is incorporated into the model to assess the effects to HIV prevalence and prevented infections. The model simulated an HIV prevalence of 16.4%, annual diagnoses of 946 infections per 100,000 MSM and antiretroviral (ART) coverage of 74.2%. PrEP as a standalone intervention at 10% and 20% intervention resulted in HIV prevalence decreasing by 3.8% and 5.4% over a 20-year intervention, respectively. A 10% increase in HIV testing combined with a PrEP intervention at 10% initiation resulted in prevalence being reduced even further, by 5.0% to 11.4%. This same intervention reduced the percentage of infected individuals that were unaware of their status from 15.6% to 6.7%. The interventions with the largest effect in reducing prevalence were the combination of PrEP and increased HIV testing. PrEP was beneficial to reducing prevalence and preventing infections even at low initiation and coverage levels