Title | Modeling Adherence Interventions Among Youth with HIV in the United States: Clinical and Economic Projections. |
Publication Type | Publication |
Year of Publication | 2021 |
Authors | Neilan AM, Bangs AC, Hudgens M, Patel K, Agwu AL, Bassett IV, Gaur AH, Hyle EP, Crespi CM, Horvath KJ, Dugdale CM, Powers KA, H Rendina J, Weinstein MC, Walensky RP, Freedberg KA, Ciaranello AL |
Journal | AIDS Behav |
Volume | 25 |
Issue | 9 |
Pagination | 2973-2984 |
Date Published | 2021 Sep |
ISSN | 1573-3254 |
Keywords | Adolescent, Cost-Benefit Analysis, HIV Infections, Humans, Quality-Adjusted Life Years, United States |
Abstract | <p>The Adolescent Medicine Trials Network for HIV/AIDS Interventions is evaluating treatment adherence interventions (AI) to improve virologic suppression (VS) among youth with HIV (YWH). Using a microsimulation model, we compared two strategies: standard-of-care (SOC) and a hypothetical 12-month AI that increased cohort-level VS in YWH in care by an absolute ten percentage points and cost $100/month/person. Projected outcomes included primary HIV transmissions, deaths and life-expectancy, lifetime HIV-related costs, and incremental cost-effectiveness ratios (ICERs, $/quality-adjusted life-year [QALY]). Compared to SOC, AI would reduce HIV transmissions by 15% and deaths by 12% at 12 months. AI would improve discounted life expectancy/person by 8 months at an added lifetime cost/person of $5,300, resulting in an ICER of $7,900/QALY. AI would be cost-effective at $2,000/month/person or with efficacies as low as a 1 percentage point increase in VS. YWH-targeted adherence interventions with even modest efficacy could improve life expectancy, prevent onward HIV transmissions, and be cost-effective.</p> |
DOI | 10.1007/s10461-021-03169-0 |
Alternate Journal | AIDS Behav |
PubMed ID | 33547993 |
PubMed Central ID | PMC8342630 |
Grant List | U24 HD089880 / HD / NICHD NIH HHS / United States K01 HHL123349 / HL / NHLBI NIH HHS / United States K08 HD 094638 / / Eunice Kennedy Shriver National Institute of Child Health and Human Development / R01 AI042006 / AI / NIAID NIH HHS / United States K01 HL123349 / HL / NHLBI NIH HHS / United States K24 AI141036 / AI / NIAID NIH HHS / United States P30 AI060354 / AI / NIAID NIH HHS / United States K08 HD094638 / HD / NICHD NIH HHS / United States U24HD089880 / / Adolescent Medicine Trials Network for HIV/AIDS Interventions / R01 HD079214 / HD / NICHD NIH HHS / United States |