TY - JOUR
T1 - The effects of free condom distribution on HIV and other sexually transmitted infections in men who have sex with men
AU - Bom, Reinier J. M.
AU - van der Linden, Kalja
AU - Matser, Amy
AU - Poulin, Nicolas
AU - Schim van der Loeff, Maarten F.
AU - Bakker, Bouko H. W.
AU - van Boven, Theodoor F.
N1 - Funding Information: 1Condomerie, Amsterdam, the Netherlands. 2Department of Research, Cluster of Infectious Diseases, Public Health Service of Amsterdam (GGD Amsterdam), Amsterdam, the Netherlands. 3Julius Center for Health Sciences & Primary Care, University Medical Center Utrecht (UMCU), Utrecht University (UU), Utrecht, the Netherlands. 4Centre de Statistique de Strasbourg (CeStatS), Institut de Recherche Mathématique Avancée (IRMA, UMR 7501), Université de Strasbourg & Centre National de la Recherche Scientifique (CNRS), Strasbourg, France. 5Center for Infection and Immunology Amsterdam (CINIMA), Academic Medical Center (AMC), University of Amsterdam (UvA), Amsterdam, the Netherlands. 6Rutgers, Utrecht, the Netherlands. Publisher Copyright: © 2019 The Author(s). Copyright: Copyright 2019 Elsevier B.V., All rights reserved.
PY - 2019/3/4
Y1 - 2019/3/4
N2 - Background: HIV and other sexually transmitted infections remain a burden on men who have sex with men in the era of effective combination antiretroviral therapy. New prevention efforts are therefore needed. One of these approaches is the current country-wide free condom distribution at gay bars with darkrooms and gay saunas in the Netherlands. This study assessed the effects of free condom distribution on incidence and burden of disease of HIV and other sexually transmitted infections. Methods: A static model was constructed to calculate the impact of free condom distribution on HIV, hepatitis C, chlamydia, gonorrhoea, and syphilis among men who have sex with men visiting these venues. Outcomes included new infections averted and disability-adjusted life years averted. Scenario studies were performed to predict the effects of a further increase of condom use, condom effectiveness and coverage. Lastly, cost-effectiveness and sensitivity analyses were performed. Results: Our model showed that condom use at public sex venues increased after the intervention. Annual incidence risk decreased, ranging from 5.73% for gonorrhoea to 7.62% for HIV. The annual number of new infections averted was largest for chlamydia and gonorrhoea (261 and 394 infections, respectively), but 42 new HIV infections were averted as well. In scenarios where condom use and condom effectiveness were further increased, the number of infections reduced more extensively. Over 99% of the decrease in burden of disease was due to HIV. The intervention was cost-effective and cost-saving (for every €1 spent on condom distribution, €5.51 was saved) and remained this in all sensitivity analyses. Conclusions: Free condoms at public sex venues could reduce the transmission of HIV and other sexually transmitted infections. Condom distribution is an affordable and easily implemented intervention that could reduce the burden of disease in men who have sex with men substantially.
AB - Background: HIV and other sexually transmitted infections remain a burden on men who have sex with men in the era of effective combination antiretroviral therapy. New prevention efforts are therefore needed. One of these approaches is the current country-wide free condom distribution at gay bars with darkrooms and gay saunas in the Netherlands. This study assessed the effects of free condom distribution on incidence and burden of disease of HIV and other sexually transmitted infections. Methods: A static model was constructed to calculate the impact of free condom distribution on HIV, hepatitis C, chlamydia, gonorrhoea, and syphilis among men who have sex with men visiting these venues. Outcomes included new infections averted and disability-adjusted life years averted. Scenario studies were performed to predict the effects of a further increase of condom use, condom effectiveness and coverage. Lastly, cost-effectiveness and sensitivity analyses were performed. Results: Our model showed that condom use at public sex venues increased after the intervention. Annual incidence risk decreased, ranging from 5.73% for gonorrhoea to 7.62% for HIV. The annual number of new infections averted was largest for chlamydia and gonorrhoea (261 and 394 infections, respectively), but 42 new HIV infections were averted as well. In scenarios where condom use and condom effectiveness were further increased, the number of infections reduced more extensively. Over 99% of the decrease in burden of disease was due to HIV. The intervention was cost-effective and cost-saving (for every €1 spent on condom distribution, €5.51 was saved) and remained this in all sensitivity analyses. Conclusions: Free condoms at public sex venues could reduce the transmission of HIV and other sexually transmitted infections. Condom distribution is an affordable and easily implemented intervention that could reduce the burden of disease in men who have sex with men substantially.
KW - Behavioural interventions
KW - Chlamydia
KW - Condoms
KW - Cost effectiveness studies
KW - Gonorrhoea
KW - HIV
KW - Hepatitis C.
KW - Men who have sex with men
KW - Models/projections
KW - Prevention of sexual transmission
KW - STI
KW - Syphilis
UR - http://www.scopus.com/inward/record.url?scp=85062414119&partnerID=8YFLogxK
U2 - https://doi.org/10.1186/s12879-019-3839-0
DO - https://doi.org/10.1186/s12879-019-3839-0
M3 - Article
C2 - 30832608
SN - 1471-2334
VL - 19
JO - BMC Infectious Diseases
JF - BMC Infectious Diseases
IS - 1
M1 - 222
ER -