Individual HIV Risk versus Population Impact of Risk Compensation after HIV Preexposure Prophylaxis Initiation among Men Who Have Sex with Men
The expected rate of HIV acquisition per 1000 discordant exposures for all MSM (Panel A), and for MSM who were currently using PrEP (Panel B) or not using PrEP at the time of exposure (Panel C), by the interaction of relative levels of condom-related risk compensation (RC) and PrEP medication adherence profile in which compensation occurred. Panel D shows the amount of person-time on PrEP per 100 possible person-weeks for susceptible MSM. The red line depicts RC in all four PrEP adherence profiles (high, medium, low, and non-adherent), the blue in the top three (high, medium, low) green in the top two (high and medium) and purple in the high only. The horizontal dashed lines shows a comparison of the two outcomes (incidence and PIA) if RC were not to occur (0% RC). All points summarize the empirical distribution of 250 simulations of each scenario.