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The Potential Epidemiological Impact of Coronavirus Disease 2019 (COVID-19) on the Human Immunodeficiency Virus (HIV) Epidemic and the Cost-effectiveness of Linked, Opt-out HIV Testing: A Modeling Study in 6 US Cities.
Zang, Xiao; Krebs, Emanuel; Chen, Siyuan; Piske, Micah; Armstrong, Wendy S; Behrends, Czarina N; Del Rio, Carlos; Feaster, Daniel J; Marshall, Brandon D L; Mehta, Shruti H; Mermin, Jonathan; Metsch, Lisa R; Schackman, Bruce R; Strathdee, Steffanie A; Nosyk, Bohdan.
  • Zang X; Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island, USA.
  • Krebs E; British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada.
  • Chen S; Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada.
  • Piske M; British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada.
  • Armstrong WS; Division of Infectious Diseases, Department of Medicine, Emory University, Atlanta, Georgia, USA.
  • Behrends CN; Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, New York, USA.
  • Del Rio C; Division of Infectious Diseases, Department of Medicine, Emory University, Atlanta, Georgia, USA.
  • Feaster DJ; Department of Public Health Sciences, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, USA.
  • Marshall BDL; Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island, USA.
  • Mehta SH; Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA.
  • Mermin J; National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
  • Metsch LR; Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, New York, USA.
  • Schackman BR; Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, New York, USA.
  • Strathdee SA; School of Medicine, University of California San Diego, La Jolla, California, USA.
  • Nosyk B; British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada.
Clin Infect Dis ; 72(11): e828-e834, 2021 06 01.
Article in English | MEDLINE | ID: covidwho-1249293
Semantic information from SemMedBD (by NLM)
1. COVID-19 AFFECTS Acquired Immunodeficiency Syndrome
Subject
COVID-19
Predicate
AFFECTS
Object
Acquired Immunodeficiency Syndrome
2. HIV LOCATION_OF IMPACT gene
Subject
HIV
Predicate
LOCATION_OF
Object
IMPACT gene
3. HIV screen DIAGNOSES HIV Infections
Subject
HIV screen
Predicate
DIAGNOSES
Object
HIV Infections
4. COVID-19 AFFECTS Acquired Immunodeficiency Syndrome
Subject
COVID-19
Predicate
AFFECTS
Object
Acquired Immunodeficiency Syndrome
5. HIV LOCATION_OF IMPACT gene
Subject
HIV
Predicate
LOCATION_OF
Object
IMPACT gene
6. HIV screen DIAGNOSES HIV Infections
Subject
HIV screen
Predicate
DIAGNOSES
Object
HIV Infections
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)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: HIV Infections / Epidemics / COVID-19 Type of study: Diagnostic study / Health economic evaluation / Prognostic study Limits: Adult / Humans Language: English Journal: Clin Infect Dis Journal subject: Communicable Diseases Year: 2021 Document Type: Article Affiliation country: Cid

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Full text: Available Collection: International databases Database: MEDLINE Main subject: HIV Infections / Epidemics / COVID-19 Type of study: Diagnostic study / Health economic evaluation / Prognostic study Limits: Adult / Humans Language: English Journal: Clin Infect Dis Journal subject: Communicable Diseases Year: 2021 Document Type: Article Affiliation country: Cid