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Estimating the potential value of MSM-focused evidence-based implementation interventions in three Ending the HIV Epidemic jurisdictions in the United States: a model-based analysis.

التفاصيل البيبلوغرافية
العنوان: Estimating the potential value of MSM-focused evidence-based implementation interventions in three Ending the HIV Epidemic jurisdictions in the United States: a model-based analysis.
المؤلفون: Enns B; Centre for Advancing Health Outcomes, Vancouver, British Columbia, Canada., Sui Y; Centre for Advancing Health Outcomes, Vancouver, British Columbia, Canada., Guerra-Alejos BC; Centre for Advancing Health Outcomes, Vancouver, British Columbia, Canada., Humphrey L; Centre for Advancing Health Outcomes, Vancouver, British Columbia, Canada., Piske M; Centre for Advancing Health Outcomes, Vancouver, British Columbia, Canada., Zang X; School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA., Doblecki-Lewis S; Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami, Florida, USA., Feaster DJ; Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA., Frye VA; School of Social Work, Columbia University, New York, New York, USA., Geng EH; Center for Dissemination and Implementation, Institute for Public Health, Division of Infectious Diseases, Department of Medicine, School of Medicine, Washington University in St. Louis, St. Louis, Missouri, USA., Liu AY; Bridge HIV, San Francisco Department of Public Health, San Francisco, California, USA., Marshall BDL; Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island, USA., Rhodes SD; Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA., Sullivan PS; School of Public Health, Emory University, Atlanta, Georgia, USA., Nosyk B; Centre for Advancing Health Outcomes, Vancouver, British Columbia, Canada.; Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada.
مؤلفون مشاركون: localized economic modelling study group
المصدر: Journal of the International AIDS Society [J Int AIDS Soc] 2024 Jul; Vol. 27 Suppl 1, pp. e26265.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: John Wiley & Sons, Inc Country of Publication: Switzerland NLM ID: 101478566 Publication Model: Print Cited Medium: Internet ISSN: 1758-2652 (Electronic) Linking ISSN: 17582652 NLM ISO Abbreviation: J Int AIDS Soc Subsets: MEDLINE
أسماء مطبوعة: Publication: 2017- : Hoboken, NJ : John Wiley & Sons, Inc
Original Publication: [London] : BioMed Central
مواضيع طبية MeSH: HIV Infections*/prevention & control , HIV Infections*/epidemiology , HIV Infections*/diagnosis , Cost-Benefit Analysis* , Pre-Exposure Prophylaxis*/methods , Pre-Exposure Prophylaxis*/economics , Homosexuality, Male*, Humans ; Male ; Epidemics/prevention & control ; United States/epidemiology ; Adult ; Georgia/epidemiology ; Los Angeles/epidemiology ; Florida/epidemiology ; Young Adult ; HIV Testing/methods
مستخلص: Introduction: Improving the delivery of existing evidence-based interventions to prevent and diagnose HIV is key to Ending the HIV Epidemic in the United States. Structural barriers in the access and delivery of related health services require municipal or state-level policy changes; however, suboptimal implementation can be addressed directly through interventions designed to improve the reach, effectiveness, adoption or maintenance of available interventions. Our objective was to estimate the cost-effectiveness and potential epidemiological impact of six real-world implementation interventions designed to address these barriers and increase the scale of delivery of interventions for HIV testing and pre-exposure prophylaxis (PrEP) in three US metropolitan areas.
Methods: We used a dynamic HIV transmission model calibrated to replicate HIV microepidemics in Atlanta, Los Angeles (LA) and Miami. We identified six implementation interventions designed to improve HIV testing uptake ("Academic detailing for HIV testing," "CyBER/testing," "All About Me") and PrEP uptake/persistence ("Project SLIP," "PrEPmate," "PrEP patient navigation"). Our comparator scenario reflected a scale-up of interventions with no additional efforts to mitigate implementation and structural barriers. We accounted for potential heterogeneity in population-level effectiveness across jurisdictions. We sustained implementation interventions over a 10-year period and evaluated HIV acquisitions averted, costs, quality-adjusted life years and incremental cost-effectiveness ratios over a 20-year time horizon (2023-2042).
Results: Across jurisdictions, implementation interventions to improve the scale of HIV testing were most cost-effective in Atlanta and LA (CyBER/testing cost-saving and All About Me cost-effective), while interventions for PrEP were most cost-effective in Miami (two of three were cost-saving). We estimated that the most impactful HIV testing intervention, CyBER/testing, was projected to avert 111 (95% credible interval: 110-111), 230 (228-233) and 101 (101-103) acquisitions over 20 years in Atlanta, LA and Miami, respectively. The most impactful implementation intervention to improve PrEP engagement, PrEPmate, averted an estimated 936 (929-943), 860 (853-867) and 2152 (2127-2178) acquisitions over 20 years, in Atlanta, LA and Miami, respectively.
Conclusions: Our results highlight the potential impact of interventions to enhance the implementation of existing evidence-based interventions for the prevention and diagnosis of HIV.
(© 2024 The Author(s). Journal of the International AIDS Society published by John Wiley & Sons Ltd on behalf of International AIDS Society.)
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معلومات مُعتمدة: R01DA041747 National Institutes on Drug Abuse
فهرسة مساهمة: Keywords: HIV; cost‐effectiveness; economic evaluation; implementation science; men who have sex with men; simulation modelling
تواريخ الأحداث: Date Created: 20240705 Date Completed: 20240705 Latest Revision: 20240707
رمز التحديث: 20240707
مُعرف محوري في PubMed: PMC11224592
DOI: 10.1002/jia2.26265
PMID: 38965982
قاعدة البيانات: MEDLINE
الوصف
تدمد:1758-2652
DOI:10.1002/jia2.26265