Tags

Type your tag names separated by a space and hit enter

Modeling the impact of HIV chemoprophylaxis strategies among men who have sex with men in the United States: HIV infections prevented and cost-effectiveness.
AIDS. 2008 Sep 12; 22(14):1829-39.AIDS

Abstract

BACKGROUND AND OBJECTIVE

HIV chemoprophylaxis may be a future prevention strategy to help control the global epidemic of HIV/AIDS. Safety and efficacy trials of two agents are currently underway. We assess the expected number of HIV cases prevented and cost-effectiveness of a hypothetical HIV chemoprophylaxis program among men who have sex with men in a large US city.

DESIGN AND METHODS

We developed a stochastic compartmental mathematical model using HIV/AIDS surveillance data to simulate the HIV epidemic and the impact of a 5-year chemoprophylaxis program under varying assumptions for epidemiological, behavioral, programmatic and cost parameters. We estimated program effectiveness and costs from the perspective of the US healthcare system compared with current HIV prevention practices. The main outcome measures were number of HIV infections prevented and incremental cost per quality-adjusted life-years saved.

RESULTS

A chemoprophylaxis program targeting 25% of high-risk men who have sex with men in New York City could prevent 780 (4%) to 4510 (23%) of the 19 510 HIV infections predicted to occur among all men who have sex with men in New York City in 5 years. More than half of prevented infections would be among those not taking chemoprophylaxis but who benefit from reduced HIV prevalence in the community. Under base-case assumptions, incremental cost was US$ 31 970 per quality-adjusted life-years saved. The program was cost-effective under most variations in efficacy, mechanism of protection and adherence.

CONCLUSION

HIV chemoprophylaxis among high-risk men who have sex with men in a major US city could prevent a significant number of HIV infections and be cost-effective.

Authors+Show Affiliations

Department of Infectious Disease Epidemiology, Imperial College London, Norfolk Place, London, UK. kamal.desai@imperial.ac.ukNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

18753932

Citation

Desai, Kamal, et al. "Modeling the Impact of HIV Chemoprophylaxis Strategies Among Men Who Have Sex With Men in the United States: HIV Infections Prevented and Cost-effectiveness." AIDS (London, England), vol. 22, no. 14, 2008, pp. 1829-39.
Desai K, Sansom SL, Ackers ML, et al. Modeling the impact of HIV chemoprophylaxis strategies among men who have sex with men in the United States: HIV infections prevented and cost-effectiveness. AIDS. 2008;22(14):1829-39.
Desai, K., Sansom, S. L., Ackers, M. L., Stewart, S. R., Hall, H. I., Hu, D. J., Sanders, R., Scotton, C. R., Soorapanth, S., Boily, M. C., Garnett, G. P., & McElroy, P. D. (2008). Modeling the impact of HIV chemoprophylaxis strategies among men who have sex with men in the United States: HIV infections prevented and cost-effectiveness. AIDS (London, England), 22(14), 1829-39. https://doi.org/10.1097/QAD.0b013e32830e00f5
Desai K, et al. Modeling the Impact of HIV Chemoprophylaxis Strategies Among Men Who Have Sex With Men in the United States: HIV Infections Prevented and Cost-effectiveness. AIDS. 2008 Sep 12;22(14):1829-39. PubMed PMID: 18753932.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Modeling the impact of HIV chemoprophylaxis strategies among men who have sex with men in the United States: HIV infections prevented and cost-effectiveness. AU - Desai,Kamal, AU - Sansom,Stephanie L, AU - Ackers,Marta L, AU - Stewart,Scott R, AU - Hall,H Irene, AU - Hu,Dale J, AU - Sanders,Rachel, AU - Scotton,Carol R, AU - Soorapanth,Sada, AU - Boily,Marie-Claude, AU - Garnett,Geoffrey P, AU - McElroy,Peter D, PY - 2008/8/30/pubmed PY - 2008/10/23/medline PY - 2008/8/30/entrez SP - 1829 EP - 39 JF - AIDS (London, England) JO - AIDS VL - 22 IS - 14 N2 - BACKGROUND AND OBJECTIVE: HIV chemoprophylaxis may be a future prevention strategy to help control the global epidemic of HIV/AIDS. Safety and efficacy trials of two agents are currently underway. We assess the expected number of HIV cases prevented and cost-effectiveness of a hypothetical HIV chemoprophylaxis program among men who have sex with men in a large US city. DESIGN AND METHODS: We developed a stochastic compartmental mathematical model using HIV/AIDS surveillance data to simulate the HIV epidemic and the impact of a 5-year chemoprophylaxis program under varying assumptions for epidemiological, behavioral, programmatic and cost parameters. We estimated program effectiveness and costs from the perspective of the US healthcare system compared with current HIV prevention practices. The main outcome measures were number of HIV infections prevented and incremental cost per quality-adjusted life-years saved. RESULTS: A chemoprophylaxis program targeting 25% of high-risk men who have sex with men in New York City could prevent 780 (4%) to 4510 (23%) of the 19 510 HIV infections predicted to occur among all men who have sex with men in New York City in 5 years. More than half of prevented infections would be among those not taking chemoprophylaxis but who benefit from reduced HIV prevalence in the community. Under base-case assumptions, incremental cost was US$ 31 970 per quality-adjusted life-years saved. The program was cost-effective under most variations in efficacy, mechanism of protection and adherence. CONCLUSION: HIV chemoprophylaxis among high-risk men who have sex with men in a major US city could prevent a significant number of HIV infections and be cost-effective. SN - 1473-5571 UR - https://www.unboundmedicine.com/medline/citation/18753932/Modeling_the_impact_of_HIV_chemoprophylaxis_strategies_among_men_who_have_sex_with_men_in_the_United_States:_HIV_infections_prevented_and_cost_effectiveness_ L2 - https://doi.org/10.1097/QAD.0b013e32830e00f5 DB - PRIME DP - Unbound Medicine ER -