Karen Schneider

A Cost-effectiveness Analysis of HIV Preexposure Prophylaxis for Men Who Have Sex With Men in Australia

BACKGROUND Antiretroviral therapy (ART) used as preexposure prophylaxis (PrEP) by human immunodeficiency virus (HIV)-seronegative individuals reduces the risk of acquiring HIV. However, the population-level impact and cost-effectiveness of using PrEP as a public health intervention remains debated. METHODS We used a stochastic agent-based model of HIV transmission and progression to simulate the clinical and cost outcomes of different strategies of providing PrEP to men who have sex with men (MSM) in New South Wales (NSW), Australia. Model outcomes were reported as incremental cost-effectiveness ratios (ICERs) in 2013 Australian dollars per quality-adjusted life-year gained (QALYG). RESULTS The use of PrEP in 10%-30% of the entire NSW MSM population was projected to cost an additional

Consensual Sex Between Men and Sexual Violence in Australian Prisons

316-

Economic evaluation of monitoring virologic responses to antiretroviral therapy in HIV-infected children in resource-limited settings.

952 million over the course of 10 years, and cost >

The Decline in Sexual Assaults in Men's Prisons in New South Wales: A "systems" Approach

400 000 per QALYG compared with the status quo. Targeting MSM with sexual partners ranging between >10 to >50 partners within 6 months cost an additional

Expected epidemiological impacts of introducing an HIV vaccine in Thailand: A model-based analysis

31-

Sexual practices and dental dam use among women prisoners – a mixed methods study

331 million dollars, and cost >

The Potential Cost and Benefits of Raltegravir in Simplified Second-Line Therapy among HIV Infected Patients in Nigeria and South Africa

110 000 per QALYG compared with the status quo. We found that preexposure prophylaxis is most cost-effective when targeted for HIV-negative MSM in a discordant regular partnership. The ICERs ranged between

Do women use dental dams? Safer sex practices of lesbians and other women who have sex with women.

8399 and

Psychological distress and experience of sexual and physical assault among Australian prisoners.

11 575, for coverage ranging between 15% and 30%, respectively. CONCLUSIONS Targeting HIV-negative MSM in a discordant regular partnership is a cost-effective intervention. However, this highly targeted strategy would not have large population-level impact. Other scenarios are unlikely to be cost-effective.

Women in contact with the Sydney gay and lesbian community: Report of the Sydney Women and Sexual Health (SWASH) Survey 2006, 2008, 2010, 2012, 2014

Estimates of the incidence of sexual coercion in men’s prisons are notoriously variable and fraught with conceptual and methodological problems. In 2006–2007, we conducted a computer-assisted telephone survey of a random sample of 2,018 male prisoners in New South Wales and Queensland. Of 2,626 eligible and available inmates, 76.8% consented and provided full responses. We asked about time in prison, sexual experience, attraction and (homo/bi/heterosexual) identity, attitudes, sexual contact with other inmates, reasons for having sex and practices engaged in, and about sexual coercion, including location and number of perpetrators. Most men (95.1%) identified as heterosexual. Of the total sample, 13.5% reported sexual contact with males in their lifetime: 7.8% only outside prison, 2.8% both inside and outside, and 2.7% only inside prison. Later in the interview, 144 men (7.1% of total sample) reported sexual contact with inmates in prison; the majority had few partners and no anal intercourse. Most did so for pleasure, but some for protection, i.e., to avoid assault by someone else. Before incarceration, 32.9% feared sexual assault in prison; 6.9% had been sexually threatened in prison and 2.6% had been sexually coerced (“forced or frightened into doing something sexually that [they] did not want”). Some of those coerced reported no same-sex contact. The majority of prisoners were intolerant of male-to-male sexual activity. The study achieved a high response rate and asked detailed questions to elicit reports of coercion and sex separately. Both consensual sex and sexual assault are less common than is generally believed.