Optimal Uses of Antiretrovirals for Prevention in HIV-1 Serodiscordant Heterosexual Couples in South Africa: A Modelling Study

Hallett, Timothy B.; Baeten, Jared M.; Heffron, Renee; Barnabas, Ruanne V.; Bruyn, Guy de; Cremin, Íde; Delany, Sinéad; Garnett, Geoffrey P.; Gray, Glenda; Johnson, Leigh F.; McIntyre, James; Rees, Helen; Celum, Connie

doi:10.1371/journal.pmed.1001123

Cited by 132 publications

(128 citation statements)

References 53 publications

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“…Before this last year, only one study had evaluated the cost-effectiveness of PrEP among serodifferent couples (37). They had found that PrEP could be highly cost-effective in this population group and even cost-saving.…”

Section: Cost-effectiveness Of Pre-exposure Prophylaxis Among Sero-dimentioning

confidence: 99%

What do we know about the cost–effectiveness of HIV preexposure prophylaxis, and is it affordable?

Cambiano¹,

Miners

Phillips³

2016

Current Opinion in HIV and AIDS

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Purpose of reviewThe World Health Organization recommends Pre-Exposure Prophylaxis (PrEP) in populations at substantial risk of HIV. Despite a number of randomized controlled trials demonstrating its efficacy, and several ongoing implementation projects, PrEP is currently only available in a few countries.Modelling studies can provide useful insights into the long term impact of introducing PrEP in different subgroups of the population. This review summarizes studies that either evaluated the cost-effectiveness or the cost of introducing PrEP, focusing on seven published in the last year. Recent findingsThese studies used a number of different types of models and investigated the introduction of PrEP in different settings. Among men having sex with men in North America, PrEP ranged from being cost-saving (while benefiting population health) to costing $160,000/quality-adjusted life-year gained. Among heterosexual sero-different couples it varied from around $5,000 to $10,000/disability-adjusted life-year averted, when PrEP was used until six or twelve months after the HIV positive partner had initiated ART in, respectively, Uganda and South Africa. SummaryFuture cost-effectiveness studies of PrEP should consider the HIV incidence, the level of uptake, the effect of its introduction on alternative prevention approaches and the budget impact of rolling it out.

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Section: Cost-effectiveness Of Pre-exposure Prophylaxis Among Sero-dimentioning

confidence: 99%

What do we know about the cost–effectiveness of HIV preexposure prophylaxis, and is it affordable?

Cambiano¹,

Miners

Phillips³

2016

Current Opinion in HIV and AIDS

View full text Add to dashboard Cite

show abstract

“…One recent study modeled combinations of expanded ART and PrEP, 25 although the study omitted secondary HIV transmission, which we find to be an important consideration. A challenge with modeling the HIV epidemic is its nonadditive nature due to overlaps in program participants, behavior modification in response to program availability, and the non-linear spread of infectious diseases.…”

Section: Introductionmentioning

confidence: 99%

Portfolios of Biomedical HIV Interventions in South Africa: A Cost-Effectiveness Analysis

Long

Stavert

2013

J GEN INTERN MED

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“…46,47 Along the same lines-and reflecting concerns about HIV transmission-the most recent US treatment guidelines from the Department of Health and Human Services support the use of antiretroviral drugs for anyone who is infected with HIV, irrespective of disease stage or whether patients are part of a serodiscordant couple. 48 The PEPFAR Scientific Advisory Board decided that exclusive focus on discordant couples would greatly limit the potential role of treatment as prevention.…”

Section: Translating Hptn 052 Findings To Programsmentioning

confidence: 99%

HIV Treatment As Prevention: How Scientific Discovery Occurred And Translated Rapidly Into Policy For The Global Response

Cohen

Holmes²,

Padian³

et al. 2012

Health Affairs

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Optimal Uses of Antiretrovirals for Prevention in HIV-1 Serodiscordant Heterosexual Couples in South Africa: A Modelling Study

Abstract: Hallett et al use a mathematical model to examine the long-term impact and cost-effectiveness of different pre-exposure prophylaxis (PrEP) strategies for HIV prevention in serodiscordant couples.

Cited by 132 publications

References 53 publications

What do we know about the cost–effectiveness of HIV preexposure prophylaxis, and is it affordable?

What do we know about the cost–effectiveness of HIV preexposure prophylaxis, and is it affordable?

Portfolios of Biomedical HIV Interventions in South Africa: A Cost-Effectiveness Analysis

HIV Treatment As Prevention: How Scientific Discovery Occurred And Translated Rapidly Into Policy For The Global Response

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