Table 2.
Summary of magnitudes of disruptions modelled, with sources
| Overall data-driven reduction used in main scenario | Age-specific or race-specific reductions used in main scenario | Overall reduction used in sensitivity analysis | Data sources | |
|---|---|---|---|---|
| HIV testing (off PrEP) | 20% | Age 18–24 years 25%; age ≥25 years 19% | 50%, 75%, 100% | Reported access to testing and difficulty getting an HIV test, overall and by age, national online survey of 1051 US MSM recruited through social media and websites in April–May, 2020;2 consistent with reported prevented access to HIV testing in another national online survey of 518 US MSM recruited through social-networking sites and hook-up apps in April–May, 202017 |
| ART initiations | 50% | .. | 50%, 75%, 100% | Assumption; qualitative reports in April, 2020, of HIV outreach disruptions in Baltimore11 |
| Viral suppression | 10% | White 9%; Black 15% | 10%, 25%, 50% | Reported proportion having fewer viral-load or other laboratory tests, reduced access to HIV medications, difficulty getting an ART prescription, taking medications daily less often—from national online survey of 1051 US MSM;2 race differences from reported ART access in a global online survey of 2732 MSM recruited through a gay social-networking app in April–May, 2020, stratified by whether MSM were members of a racial or ethnic minority group21 |
| PrEP initiations | 72% | .. | 50%, 75%, 100% | Numbers of PrEP initiations at a Boston PrEP clinic in April, 2020, vs January, 2020 (cohort of 3250 patients on PrEP)12 |
| PrEP adherence | 9% | Black, aged 18–24 years 13%; White, aged 18–24 years 11%; Black, aged ≥25 years 9%; White, aged ≥25 years 8% | 10%, 25%, 50% | Numbers of excess missed PrEP refills during lockdown out of the total number of patients on PrEP at a Boston PrEP clinic (cohort of 3250 patients on PrEP),12 reported difficulty getting a PrEP prescription or medication from two national online surveys of US MSM (n=1051 and n=518);2, 17 age and race differences from the proportion of missed PrEP refills by age and race in April, 2020, at a Boston PrEP clinic12 |
| HIV testing (on PrEP) | 85% | .. | 50%, 75%, 100% | From numbers of HIV tests done at a Boston PrEP clinic in April, 2020, vs January, 2020 (cohort of 3250 patients on PrEP)12 |
| Condom use | 5% | .. | 10%, 25%, 50% | From reported change in condom use in a national online survey of 1051 US MSM2 |
| Partner numbers | 0%, 25%, 50% | Age 18–24 years 0%, 22%, 44%; age ≥25 years 0%, 26%, 52% | 10%, 25%, 50% | 0% disruption from change in numbers of casual sex partners in national online MSM cohorts recruited through social-networking apps in May, 2020, vs November, 2017, to November, 2019,18 change in unprotected sexual partners reported in a national online survey of 518 US MSM;17 25% and 50% disruption from the proportion reporting fewer sexual partners in two national online surveys of US MSM (n=1051 and n=728) recruited through social-networking sites or hook up apps,2, 10 assuming these individuals reduced their number of partners by 50–100%; age differences from the proportion reporting fewer sexual partners in a national online survey of US MSM2 |
ART=antiretroviral therapy. MSM=men who have sex with men. PrEP=pre-exposure prophylaxis.