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Several prospective, randomized trials are currently under way to determine the safety and efficacy of antiretrovirals for preexposure prophylaxis (PrEP). If the results of those trials are positive, clinicians, researchers, and policymakers will need to consider a number of issues immediately, including the cost-effectiveness of the intervention in specific populations.
To that end, investigators constructed a computer-simulation model using HIV incidence data from a cohort of men who have sex with men (MSM) in the U.S., efficacy data from macaque studies of PrEP, and cost data for tenofovir/FTC (Truvada). The base case population was a cohort of MSM (mean age, 34) with a high annual incidence of HIV infection (1.6%); PrEP was assumed to be…