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. 2020 Oct;47(10):649-657.
doi: 10.1097/OLQ.0000000000001239.

The Potential Impact of a Gel-Based Point-of-Sex Intervention in Reducing Gonorrhea Incidence Among Gay and Bisexual Men: A Modeling Study

Michael W Traeger, Tom Tidhar  1 , Martin Holt  2 , Chris Williams, Edwina J Wright, Mark A Stoové, Nick Scott, Margaret E Hellard
Affiliations

The Potential Impact of a Gel-Based Point-of-Sex Intervention in Reducing Gonorrhea Incidence Among Gay and Bisexual Men: A Modeling Study

Michael W Traeger et al. Sex Transm Dis. 2020 Oct.

Abstract

Background: Increases in sexually transmitted infections among gay and bisexual men (GBM) over the past decade have coincided with declines in condom use and rapid uptake of HIV preexposure prophylaxis (PrEP). We explored the impact of an antimicrobial gel-based point-of-sex intervention (gel-PSI) with a lower efficacy for reducing gonorrhea transmission risk than condoms on population-level gonorrhea incidence among GBM in Victoria, Australia.

Methods: A deterministic compartmental model of HIV and gonorrhea transmission was used to project annual gonorrhea incidence from 2020 to 2025. Individuals were classified as HIV-negative (PrEP or non-PrEP users) or HIV-positive, and further stratified by gonorrhoea risk (high/low). All possible scenarios where between 0% and 100% of GBM using condoms transitioned to gel-PSI (considered a downgrade in protection) and 0% and 100% of GBM not using condoms transitioned to gel-PSI (considered an upgrade in protection), with gel-PSI efficacy ranging from 20% to 50%, were run.

Results: The baseline scenario of no gel-PSI uptake (status quo) projected 94,367 gonorrhea infections between 2020 and 2025, with an exponentially increasing trend in annual infections. For a gel-PSI efficacy of 30%, a net reduction in cumulative gonorrhea incidence was projected, relative to the status quo, for any ratio of proportion of condom users "downgrading" to proportion of noncondom users "upgrading" to gel-PSI use of less than 2.6. Under the supposition of equal proportions of condom users and noncondom users switching to gel-PSI, a relative reduction was projected for any gel-PSI efficacy greater than 16%.

Conclusions: Our model suggests that the introduction of a gel-PSI could have benefits for controlling gonorrhea transmission among GBM, even in scenarios where the gel-PSI is considerably less efficacious than condoms and when gel-PSI uptake leads to consequent reductions in consistent condom use.

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References

    1. HIV, Viral Hepatitis and Sexually Transmissible Infections in Australia: Annual Surveillance Report 2018. Sydney: Kirby Institute, University of New South Wales, 2018.
    1. Stenger MR, Pathela P, Anschuetz G, et al. Increases in the rate of Neisseria gonorrhoeae among gay, bisexual and other men who have sex with men—Findings from the Sexually Transmitted Disease Surveillance Network 2010–2015. Sex Transm Dis 2017; 44:393–397.
    1. van Bilsen WPH, Boyd A, van der Loeff MFS, et al. Diverging trends in incidence of HIV versus other sexually transmitted infections in HIV-negative MSM in Amsterdam. AIDS 2020; 34:301–309.
    1. An Q, Wejnert C, Bernstein K, et al. Syphilis screening and diagnosis among men who have sex with men, 2008–2014, 20 U.S. cities. J Acquir Immune Defic Syndr 2017; 75(Suppl 3):S363–S369.
    1. Broady T, Mao L, Bavinton B, et al. Gay Community Periodic Survey: Melbourne 2019. Sydney: Centre for Social Research in Health, UNSW Sydney.

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