Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 2 de 2
Filter
Add filters

Language
Year range
1.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-324909

ABSTRACT

Background: Widespread viral and serological testing for SARS-CoV-2 may present a unique opportunity to also test for HIV infection. We estimated the potential impact of adding linked, opt-out HIV testing alongside SARS-CoV-2 testing on HIV incidence and the cost-effectiveness of this strategy in six US cities.Methods: We calibrated a dynamic compartmental HIV transmission model to match the epidemiological characteristics of six US cities (Atlanta, Baltimore, Los Angeles, Miami, New York City, Seattle). For each city, we constructed three sets of scenarios: (1) sustained current levels of HIV-related treatment and prevention services (status quo);(2) temporary disruptions in health services and changes in sexual and injection risk behaviours at discrete levels between 0%-50%;and (3) linked HIV and SARS-CoV-2 testing offered to 10%-90% of the adult population in addition to scenario (2). We estimated cumulative HIV infections between 2020-2025, as well as incremental costs, quality-adjusted life years, and incremental cost-effectiveness ratios of linked HIV testing over 20 years.Findings: In the absence of linked, opt-out HIV testing, we estimated a best-case scenario (50% reduction in risk behaviours and no service disruptions) of 6,733 fewer HIV infections between 2020-2025 (16.5% decrease), and a worst-case scenario (no behavioural change and 50% reduction in service access) of 3,669 additional HIV infections (9.0% increase) across cities. If HIV testing could be offered to 10%-90% of the adult population, we estimated that a total of 576-7,225 (1.6%-17.2%) new infections could be averted. The intervention would require an initial investment of $20M-$218M across cities;however, the intervention would ultimately result in savings in health care costs in each city.Interpretation: Although COVID-19-related disruptions in HIV-related services may increase or decrease HIV incidence, a campaign in which HIV testing is linked with SARS-CoV-2 testing could substantially reduce HIV incidence and reduce direct and indirect health care costs attributable to HIV.Funding Statement: US NIH-NIDA Grant No. R01-DA041747Declaration of Interests: XZ, EK, SC, MP, WSA, CNB, CDR, DJF, BDLM, SHM, JM, LRM, BRS, SAS and BN declare no competing interests.

2.
Clin Infect Dis ; 72(11): e828-e834, 2021 06 01.
Article in English | MEDLINE | ID: covidwho-1249293

ABSTRACT

BACKGROUND: Widespread viral and serological testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may present a unique opportunity to also test for human immunodeficiency virus (HIV) infection. We estimated the potential impact of adding linked, opt-out HIV testing alongside SARS-CoV-2 testing on the HIV incidence and the cost-effectiveness of this strategy in 6 US cities. METHODS: Using a previously calibrated dynamic HIV transmission model, we constructed 3 sets of scenarios for each city: (1) sustained current levels of HIV-related treatment and prevention services (status quo); (2) temporary disruptions in health services and changes in sexual and injection risk behaviors at discrete levels between 0%-50%; and (3) linked HIV and SARS-CoV-2 testing offered to 10%-90% of the adult population in addition to Scenario 2. We estimated the cumulative number of HIV infections between 2020-2025 and the incremental cost-effectiveness ratios of linked HIV testing over 20 years. RESULTS: In the absence of linked, opt-out HIV testing, we estimated a total of a 16.5% decrease in HIV infections between 2020-2025 in the best-case scenario (50% reduction in risk behaviors and no service disruptions), and a 9.0% increase in the worst-case scenario (no behavioral change and 50% reduction in service access). We estimated that HIV testing (offered at 10%-90% levels) could avert a total of 576-7225 (1.6%-17.2%) new infections. The intervention would require an initial investment of $20.6M-$220.7M across cities; however, the intervention would ultimately result in savings in health-care costs in each city. CONCLUSIONS: A campaign in which HIV testing is linked with SARS-CoV-2 testing could substantially reduce the HIV incidence and reduce direct and indirect health care costs attributable to HIV.


Subject(s)
COVID-19 , Epidemics , HIV Infections , Adult , COVID-19 Testing , Cities , Cost-Benefit Analysis , HIV , HIV Infections/diagnosis , HIV Infections/epidemiology , Humans , SARS-CoV-2
SELECTION OF CITATIONS
SEARCH DETAIL