Cost Effectiveness of HIV Prevention Interventions in the U.S.

Lin, Feng; Farnham, Paul G.; Shrestha, Ram K.; Mermin, Jonathan; Sansom, Stephanie L.

doi:10.1016/j.amepre.2016.01.011

Cited by 32 publications

(28 citation statements)

References 35 publications

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“…of transmissions averted, T is lifetime HIV treatment cost saved per transmission averted, and Q is no. of quality adjusted life years (QALYs) saved per transmission averted ; all costs and health outcomes are additional to those of the controlled arm. Threshold for cost‐effectiveness assumed to be $100,000 .…”

Section: Resultsmentioning

confidence: 99%

“… transmissions averted per new HIV diagnosis (t, 0.0696) is based on the estimated transmissions attributable to MSM aware of their HIV status (0.0516) compared with those unaware of their status (0.1212) ; …”

Section: Resultsmentioning

confidence: 99%

“…Using the additional new HIV diagnoses identified under self‐testing arm, we estimated the incremental number of HIV transmissions averted, lifetime HIV treatment costs saved, QALYs saved and cost per QALY saved . We assumed a reduction in transmission per new HIV diagnosis (0.0696), based a lower HIV transmission rate (0.0516) attributable to MSM being aware of their HIV status compared with those unaware of their status (0.1212) . We applied 4.45 quality adjusted life years (QALYs) saved per infection averted, based on the patients who were diagnosed and entered HIV care at a CD4 count of 500 cells/mL or above .…”

Section: Methodsmentioning

confidence: 99%

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Estimating the costs and cost‐effectiveness of HIV self‐testing among men who have sex with men, United States

Shrestha

Chavez

Noble³

et al. 2020

J Intern AIDS Soc

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Introduction HIV testing is an essential prerequisite for accessing treatment with antiretroviral therapy or prevention using pre‐exposure prophylaxis. Internet distribution of HIV self‐tests is a novel approach, and data on the programmatic cost of this approach are limited. We analyse the costs and cost‐effectiveness of a self‐testing programme. Methods Men who have sex with men (MSM) reporting unknown or negative HIV status were enrolled from March to August 2015 into a 12‐month trial of HIV self‐testing in the United States. Participants were randomly assigned either to the self‐testing arm or the control arm. All participants received information on HIV testing services and locations in their community. Self‐testing participants received up to four self‐tests each quarter, which they could use themselves or distribute to their social network associates. Quarterly follow‐up surveys collected testing outcomes, including number of tests used and new HIV diagnoses. Using trial expenditure data, we estimated the cost of implementing a self‐testing programme. Primary outcomes of this analysis included total programme implementation costs, cost per self‐test completed, cost per person tested, cost per new HIV diagnosis among those self‐tested and cost per quality adjusted life year (QALY) saved. Results A total of 2665 men were assigned either to the self‐testing arm (n = 1325) or the control arm (n = 1340). HIV testing was reported by 971 self‐testing participants who completed a total of 5368 tests. In the control arm, 619 participants completed 1463 HIV tests. The self‐testing participants additionally distributed 2864 self‐tests to 2152 social network associates. Testing during the trial identified 59 participants and social network associates with newly diagnosed HIV infection in the self‐testing arm; 11 control participants were newly diagnosed with HIV. The implementation cost of the HIV self‐testing programme was $449,510. The cost per self‐test completed, cost per person tested at least once, and incremental cost per new HIV diagnosis was $61, $145 and $9365 respectively. We estimated that self‐testing programme potentially averted 3.34 transmissions, saved 14.86 QALYs and nearly $1.6 million lifetime HIV treatment costs. Conclusions The HIV self‐testing programme identified persons with newly diagnosed HIV infection at low cost, and the programme is cost saving.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Estimating the costs and cost‐effectiveness of HIV self‐testing among men who have sex with men, United States

Shrestha

Chavez

Noble³

et al. 2020

J Intern AIDS Soc

View full text Add to dashboard Cite

show abstract

“…11 In countries such as many of those in sub-Saharan Africa, even though the cost of treatment might be lower than in the USA, and therefore cost-effectiveness harder to achieve, the number of undiagnosed HIV cases in sub-Saharan Africa suggests that any method that yields as many cases as shown in this study is likely to be worth the investment. For that matter, a partner services programme also reveals networks of transmission and social contact and connects people infected with HIV to life-saving health services.…”

mentioning

confidence: 80%

Assisted partner services for HIV case-finding

Hogben

Behel

2017

The Lancet HIV

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“…Our sample comprised an approximately equal proportion of sexually assertive and sexually non-assertive HIV-infected women. Despite great progress made towards eliminating HIV progression since ART, prevention remains the most cost-effective way of controlling the HIV epidemic (Günthard et al, 2016;Lin et al, 2016). Condom use is known to be the most important method in preventing sexual transmission of HIV (Smith et al, 2015).…”

Section: Discussionmentioning

confidence: 99%

"Demand what you prefer": the role of sexual assertiveness among HIV-infected women

Vakili

Alipour²,

Khoei

et al. 2019

Cent Eur J Nurs Midw

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Aim: This study was conducted to evaluate sexual assertiveness among HIV-infected women, and to address the relationship between sexual assertiveness, sociodemographic characteristics, sexual and fertility profile, and HIV-related variables in this population. Design: A cross sectional study. Methods: The research was conducted with a sample of 93 eligible HIV-infected women referred to Imam Khomeini hospital between September 2016 and January 2018. The Hurlbert Index of Sexual Assertiveness was used to assess sexual assertiveness. Results: Mean and standard deviation of sexual assertiveness was 51.33 (20.16). We found a significant relationship between age (p = 0.04), education (p = 0.03), pregnancy experience (p = 0.003), age at the time of first sexual contact (p = 0.005), and disclosure of HIV sero-status to sexual partners (p = 0.05) and sexual assertiveness. Binary logistic regression results showed that age (p = 0.04), having live children (p = 0.003), and disclosure of HIV sero-status to sexual partners (p = 0.04) could significantly predict sexual assertiveness score. Conclusion: Our findings showed that level of sexual assertiveness in HIV sero-positive women deserves more attention. In addition, consideration should be given to sexual health related issues and sexual assertiveness skills during routine HIV care appointments.

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Cost Effectiveness of HIV Prevention Interventions in the U.S.

Cited by 32 publications

References 35 publications

Estimating the costs and cost‐effectiveness of HIV self‐testing among men who have sex with men, United States

Estimating the costs and cost‐effectiveness of HIV self‐testing among men who have sex with men, United States

Assisted partner services for HIV case-finding

"Demand what you prefer": the role of sexual assertiveness among HIV-infected women

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