ArticlePloS one2012
Expanding ART for treatment and prevention of HIV in South Africa: estimated cost and cost-effectiveness 2011-2050.
Article in PloS one, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 84 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
84 citing papers in PubMed, 2 syntheses or guidelines pooled it, 174 citations in OpenAlex.
- Dynamic Transmission Economic Evaluation of Infectious Disease Interventions in Low- and Middle-Income Countries: A Systematic Literature Review.Health economics · 2016Pooled it
- Diagnostic accuracy of the WHO clinical staging system for defining eligibility for ART in sub-Saharan Africa: a systematic review and meta-analysis.Journal of the International AIDS Society · 2014Pooled it
- Cost-Effectiveness of Linkage Case Management for Hospitalized People With HIV.JAMA network open · 2025Trial
- Differences in health-related quality of life between HIV-positive and HIV-negative people in Zambia and South Africa: a cross-sectional baseline survey of the HPTN 071 (PopART) trial.The Lancet. Global health · 2017Trial
- Epidemiological trends and burden of mortality from HIV/AIDS and multidrug-resistant tuberculosis without extensive drug-resistance across Africa: A global burden of disease analysis (1990-2021).Journal of clinical tuberculosis and other mycobacterial diseases · 2025Article
- Generalized Treatment as Prevention Plus Focused Pre-Exposure Prophylaxis Is the Key to Controlling HIV/AIDS.Tropical medicine and infectious disease · 2025Review
- Micro-costing analysis of integrating SARS-CoV-2 antigen rapid detection tests into routine health facility services: a comparison of test-all versus screen-and-test models in Cameroon and Kenya.BMJ public health · 2025Article
- Cost of Providing Advanced HIV Disease Treatment Services through Malawi's Hub-and-Spoke Model.The American journal of tropical medicine and hygiene · 2024Article
- Using an app for COVID-19 contact tracing costs less per person traced than manual tracing: microcosting analysis of a randomised trial in Cameroon.BMJ public health · 2024Article
- Preventing tuberculosis with community-based care in an HIV-endemic setting: a modelling analysis.Journal of the International AIDS Society · 2024Article
- Preventing tuberculosis with community-based care in an HIV-endemic setting: a modeling analysis.medRxiv : the preprint server for health sciences · 2023Article
- Barriers and facilitators to adherence for antiretroviral therapy: the perspectives of patients from a wellness center in the Mpumalanga Province, South Africa.African health sciences · 2022Article
- A Game Theoretic Analysis of Competition Between Vaccine and Drug Companies during Disease Contraction and Recovery.Medical decision making : an international journal of the Society for Medical Decision Making · 2022Article
- Decisions of persons, the pharmaceutical industry, and donors in disease contraction and recovery assuming virus mutation.Health economics review · 2021Article
- Rheumatic Heart Disease is Missing from the Global Health Agenda.Annals of global health · 2021Review
- Optimizing Screening for HIV.Open forum infectious diseases · 2020Article
- Article
- The differential impacts of non-locally acquired infections and treatment interventions on heterosexual HIV transmission in Hong Kong.PloS one · 2020Article
- When Global ART Budgets Cannot Cover All Patients, Who Should Be Eligible?Journal of acquired immune deficiency syndromes (1999) · 2019Review
- Cost-effectiveness of HIV Prevention Interventions in Sub-Saharan Africa: A Systematic Review.EClinicalMedicine · 2019Article
24 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
19 authors at 8 institutions in 4 countries.
Funding
Abstract
backgroundAntiretroviral Treatment (ART) significantly reduces HIV transmission. We conducted a cost-effectiveness analysis of the impact of expanded ART in South Africa.
methodsWe model a best case scenario of 90% annual HIV testing coverage in adults 15-49 years old and four ART eligibility scenarios: CD4 count <200 cells/mm(3) (current practice), CD4 count <350, CD4 count <500, all CD4 levels. 2011-2050 outcomes include deaths, disability adjusted life years (DALYs), HIV infections, cost, and cost per DALY averted. Service and ART costs reflect South African data and international generic prices. ART reduces transmission by 92%. We conducted sensitivity analyses.
resultsExpanding ART to CD4 count <350 cells/mm(3) prevents an estimated 265,000 (17%) and 1.3 million (15%) new HIV infections over 5 and 40 years, respectively. Cumulative deaths decline 15%, from 12.5 to 10.6 million; DALYs by 14% from 109 to 93 million over 40 years. Costs drop $504 million over 5 years and $3.9 billion over 40 years with breakeven by 2013. Compared with the current scenario, expanding to <500 prevents an additional 585,000 and 3 million new HIV infections over 5 and 40 years, respectively. Expanding to all CD4 levels decreases HIV infections by 3.3 million (45%) and costs by $10 billion over 40 years, with breakeven by 2023. By 2050, using higher ART and monitoring costs, all CD4 levels saves $0.6 billion versus current; other ART scenarios cost $9-194 per DALY averted. If ART reduces transmission by 99%, savings from all CD4 levels reach $17.5 billion. Sensitivity analyses suggest that poor retention and predominant acute phase transmission reduce DALYs averted by 26% and savings by 7%.
conclusionIncreasing the provision of ART to <350 cells/mm3 may significantly reduce costs while reducing the HIV burden. Feasibility including HIV testing and ART uptake, retention, and adherence should be evaluated.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.