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Non-selective distribution of infectious disease prevention may outperform risk-based targeting

Medicine and Health

Non-selective distribution of infectious disease prevention may outperform risk-based targeting

B. Steinger, I. Iacopini, et al.

This groundbreaking research by Benjamin Steinger, Iacopo Iacopini, Andreia Sofia Teixeira, Alberto Bracchi, Pau Casanova-Ferrer, Alberto Antonioni, and Eugenio Valdano reveals that non-selective distribution methods for infectious disease prevention may be more effective than targeting high-risk groups, particularly when prevention efficacy falls below a critical level. Explore how this could transform HIV prevention strategies in communities.

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~3 min • Beginner • English
Abstract
Epidemic control often requires optimal distribution of available vaccines and prophylactic tools, to protect from infection those susceptible. Well-established theory recommends prioritizing those at the highest risk of exposure. But the risk is hard to estimate, especially for diseases involving stigma and marginalization. We address this conundrum by proving that one should target those at high risk only if the infection-averting efficacy of prevention is above a critical value, which we derive analytically. We apply this to the distribution of pre-exposure prophylaxis (PrEP) of the Human Immunodeficiency Virus (HIV) among men-having-sex-with-men (MSM), a population particularly vulnerable to HIV. PrEP is effective in averting infections, but its global scale-up has been slow, showing the need to revisit distribution strategies, currently risk-based. Using data from MSM communities in 58 countries, we find that non-selective PrEP distribution often outperforms risk-based, showing that a logistically simpler strategy is also more effective. Our theory may help design more feasible and successful prevention.
Publisher
Nature Communications
Published On
May 31, 2022
Authors
Benjamin Steinger, Iacopo Iacopini, Andreia Sofia Teixeira, Alberto Bracchi, Pau Casanova-Ferrer, Alberto Antonioni, Eugenio Valdano
Tags
infectious disease prevention
non-selective distribution
high-risk individuals
HIV
pre-exposure prophylaxis
public health
community health
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