Ending the HIV epidemic in the USA: an economic modelling study in six cities.

The Lancet. HIV
Bohdan NosykLocalized HIV Modeling Study Group

Abstract

The HIV epidemic in the USA is a collection of diverse local microepidemics. We aimed to identify optimal combination implementation strategies of evidence-based interventions to reach 90% reduction of incidence in 10 years, in six US cities that comprise 24·1% of people living with HIV in the USA. In this economic modelling study, we used a dynamic HIV transmission model calibrated with the best available evidence on epidemiological and structural conditions for six US cities: Atlanta (GA), Baltimore (MD), Los Angeles (CA), Miami (FL), New York City (NY), and Seattle (WA). We assessed 23 040 combinations of 16 evidence-based interventions (ie, HIV prevention, testing, treatment, engagement, and re-engagement) to identify combination strategies providing the greatest health benefit while remaining cost-effective. Main outcomes included averted HIV infections, quality-adjusted life-years (QALYs), total cost (in 2018 US$), and incremental cost-effectiveness ratio (ICER; from the health-care sector perspective, 3% annual discount rate). Interventions were implemented at previously documented and ideal (90% coverage or adoption) scale-up, and sustained from 2020 to 2030, with outcomes evaluated until 2040. Optimal combination strat...Continue Reading

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Citations

Apr 28, 2020·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Bohdan NosykCarlos Del Rio
May 20, 2020·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Bohdan NosykSteffanie A Strathdee
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Oct 8, 2020·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Steffanie A StrathdeeDavey M Smith
Oct 24, 2020·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Ravi GoyalBoyd Gilman
Nov 30, 2020·Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research·Xiao ZangBohdan Nosyk
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Mar 16, 2021·The Lancet Global Health·Jean B NachegaElvin H Geng
May 1, 2021·The Journal of the Association of Nurses in AIDS Care : JANAC·Megan ThreatsComfort Enah
Mar 7, 2021·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Patrick JanulisSamuel M Jenness
Aug 10, 2021·The Lancet. HIV·Amanda My Linh QuanUNKNOWN Localized HIV Economic Modeling Study Group
Sep 21, 2021·Annals of Internal Medicine·Benjamin P Linas
Sep 21, 2021·Annals of Internal Medicine·Anthony Todd FojoMaunank Shah
Oct 16, 2021·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Andrea GiacomelliAnna Lisa Ridolfo
Aug 28, 2020·Journal of Microbiology, Immunology, and Infection = Wei Mian Yu Gan Ran Za Zhi·Guan-Lin ChenPo-Liang Lu

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