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Using A Network-Based Approach And Targeted Maximum Likelihood Estimation To Evaluate The Effect Of Adding Pre-Exposure Prophylaxis To An Ongoing Test-And-Treat Trial, Laura Balzer, Patrick Staples, Jukka-Pekka Onnela, Victor De Gruttola
Using A Network-Based Approach And Targeted Maximum Likelihood Estimation To Evaluate The Effect Of Adding Pre-Exposure Prophylaxis To An Ongoing Test-And-Treat Trial, Laura Balzer, Patrick Staples, Jukka-Pekka Onnela, Victor De Gruttola
Laura B. Balzer
Background: Several cluster randomized trials are underway to investigate the implementation and effectiveness of a universal test-and-treat strategy on the HIV epidemic in sub-Saharan Africa. We consider nesting studies of pre-exposure prophylaxis (PrEP) within these trials. PrEP is a general strategy where high risk HIV- persons take antiretrovirals daily to reduce their risk of infection from exposure to HIV. We address how to target PrEP to high risk groups and how to maximize power to detect the individual and combined effects of universal test-and-treat and PrEP strategies.
Methods: We simulated 1000 trials, each consisting of 32 villages with 200 individuals …