ArticleAIDS (London, England)2015
Modelling the impact and cost-effectiveness of combination prevention amongst HIV serodiscordant couples in Nigeria.
Article in AIDS (London, England), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 3 of them syntheses that pooled it.
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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.
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Who cites it
28 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Evolving landscape of economic evaluations of HIV pre-exposure prophylaxis and pre-exposure prophylaxis implementation strategies: a systematic review.Journal of the International AIDS Society · 2025Pooled it
- Costs and Cost-Effectiveness of Biomedical, Non-Surgical HIV Prevention Interventions: A Systematic Literature Review.PharmacoEconomics · 2023Pooled it
- In what circumstances could nondaily preexposure prophylaxis for HIV substantially reduce program costs?AIDS (London, England) · 2018Pooled it
- Low costs and opportunities for efficiency: a cost analysis of the first year of programmatic PrEP delivery in Kenya's public sector.BMC health services research · 2021Trial
- Potential impact and cost-effectiveness of oral HIV pre-exposure prophylaxis for men who have sex with men in Cotonou, Benin: a mathematical modelling study.The Lancet. Global health · 2025Article
- Efficacy estimates of oral pre-exposure prophylaxis for HIV prevention in cisgender women with partial adherence.Nature medicine · 2023Article
- Implementation and resource needs for long-acting PrEP in low- and middle-income countries: a scoping review.Journal of the International AIDS Society · 2023Article
- Out-of-pocket Expenses and Time Spent on Clinic Visits Among HIV Pre-exposure Prophylaxis Users and Other Clinic Attendees in Eswatini.AIDS and behavior · 2023Observational
- Acceptability of and Preferences for Long-Acting Injectable HIV PrEP and Other PrEP Modalities among Sexual Minority Men in Nigeria, Africa.AIDS and behavior · 2022Article
- The Costs of Creatinine Testing in the Context of a HIV Pre-Exposure Prophylaxis Demonstration Project in Eswatini.AIDS and behavior · 2022Article
- Incremental costs of integrated PrEP provision and effective use counselling in community-based platforms for adolescent girls and young women in South Africa: an observational study.Journal of the International AIDS Society · 2022Observational
- Effectiveness of three delivery models for promoting access to pre-exposure prophylaxis in HIV-1 serodiscordant couples in Nigeria.PloS one · 2022Article
- Health economics modeling of antiretroviral interventions amongst HIV serodiscordant couples.Scientific reports · 2021Article
- HIV prevention is not all about HIV - using a discrete choice experiment among women to model how the uptake and effectiveness of HIV prevention products may also rely on pregnancy and STI protection.BMC infectious diseases · 2020Article
- Community perspectives on barriers and challenges to HIV pre-exposure prophylaxis access by men who have sex with men and female sex workers access in Nigeria.BMC public health · 2020Article
- The impact, cost and cost-effectiveness of oral pre-exposure prophylaxis in sub-Saharan Africa: a scoping review of modelling contributions and way forward.Journal of the International AIDS Society · 2019Article
- Making Smarter Decisions Faster: Systems Engineering to Improve the Global Public Health Response to HIV.Current HIV/AIDS reports · 2019Review
- The role of costing in the introduction and scale-up of HIV pre-exposure prophylaxis: evidence from integrating PrEP into routine maternal and child health and family planning clinics in western Kenya.Journal of the International AIDS Society · 2019Article
- Cost-effectiveness of option B+ in prevention of mother-to-child transmission of HIV in Yunnan Province, China.BMC infectious diseases · 2019Article
- Community Inclusion in PrEP Demonstration Projects: Lessons for Scaling Up.Gates open research · 2019Article
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
objectiveTo estimate the impact and cost-effectiveness of treatment as prevention (TasP), pre-exposure prophylaxis (PrEP) and condom promotion for serodiscordant couples in Nigeria.
designMathematical and cost modelling.
methodsA deterministic model of HIV-1 transmission within a cohort of serodiscordant couples and to/from external partners was parameterized using data from Nigeria and other African settings. The impact and cost-effectiveness were estimated for condom promotion, PrEP and/or TasP, compared with a baseline where antiretroviral therapy (ART) was offered according to 2010 national guidelines (CD4 <350 cells/μl) to all HIV-positive partners. The impact was additionally compared with a baseline of current ART coverage (35% of those with CD4 <350 cells/μl). Full costs (in US $2012) of programme introduction and implementation were estimated from a provider perspective.
resultsSubstantial benefits came from scaling up ART to all HIV-positive partners according to 2010 national guidelines, with additional smaller benefits of providing TasP, PrEP or condom promotion. Compared with a baseline of offering ART to all HIV-positive partners at the 2010 national guidelines, condom promotion was the most cost-effective strategy [US $1206/disability-adjusted-life-year (DALY)], the next most cost-effective intervention was to additionally give TasP to HIV-positive partners (incremental cost-effectiveness ratio US $1607/DALY), followed by additionally giving PrEP to HIV-negative partners until their HIV-positive partners initiate ART (US $7870/DALY). When impact was measured in terms of infections averted, PrEP with condom promotion prevented double the number of infections as condom promotion alone.
conclusionsThe first priority intervention for serodiscordant couples in Nigeria should be scaled up ART access for HIV-positive partners. Subsequent incremental benefits are greatest with condom promotion and TasP, followed by PrEP.
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