Modeling Adherence Interventions Among Youth with HIV in the United States: Clinical and Economic Projections.

TitleModeling Adherence Interventions Among Youth with HIV in the United States: Clinical and Economic Projections.
Publication TypePublication
Year of Publication2021
AuthorsNeilan 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
JournalAIDS Behav
Date Published2021 Feb 06
ISSN1573-3254
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>

DOI10.1007/s10461-021-03169-0
Alternate JournalAIDS Behav
PubMed ID33547993
Grant ListU24 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