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We built a mathematical model to describe the HIV epidemic, including acute infection and pre-exposure prophylaxis (PrEP), and projected the model to 2050. We compared current testing and treatment policies, a scenario where Japan achieves UNAIDS 90-90-90 targets, three PrEP scenarios defined by different coverage levels of 25%, 50%, and 75% among the 20% of MSM with the highest risk behavior, and combinations of these scenarios. With no change in interventions prevalence of HIV among MSM will rise to 9.0% in 2050. If Japan achieves full UNAIDS 90-90-90 targets, 84.9% of these infections would be averted. Under 50% PrEP with no expansion of testing and treatment, prevalence will reach 2.6% and 62.1% of infections would be averted by 2050. If in addition UNAIDS 90-90-90 goals are achieved, 92.7% of HIV infections would be prevented by 2050. All interventions tested in this model were cost-saving relative to the base case. Both PrEP and enhanced ART strategies can be cost-saving, and if Japan enhances its testing program for MSM and introduces PrEP, it has the potential to effectively eliminate new infections in the next 30\u00a0years.<\/jats:p>","DOI":"10.1038\/s41598-020-75182-7","type":"journal-article","created":{"date-parts":[[2020,10,23]],"date-time":"2020-10-23T10:06:00Z","timestamp":1603447560000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["New strategies for prevention of HIV among Japanese men who have sex with men: a mathematical model"],"prefix":"10.1038","volume":"10","author":[{"given":"Stuart","family":"Gilmour","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liping","family":"Peng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinghua","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinichi","family":"Oka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junko","family":"Tanuma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,10,23]]},"reference":[{"key":"75182_CR1","unstructured":"AIDS Prevention Information Network, Report on HIV\/AIDS trends in Japan, API-Net, Editor. 2018, AIDS Prevention Information Network: Tokyo."},{"key":"75182_CR2","first-page":"71","volume":"19","author":"S Ichikawa","year":"2017","unstructured":"Ichikawa, S. 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