ArticleMedical decision making : an international journal of the Society for Medical Decision Making2016
HIV Treatment and Prevention: A Simple Model to Determine Optimal Investment.
Article in Medical decision making : an international journal of the Society for Medical Decision Making, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
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Who cites it
13 citing papers in PubMed, 2 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
- A systematic review of whole disease models for informing healthcare resource allocation decisions.PloS one · 2023Pooled it
- Informing the Equitable Implementation of Hepatitis C Interventions: Cost-Effectiveness Modeling in Rural Populations of People Who Inject Drugs.PharmacoEconomics · 2026Article
- A Multi-Agent Reinforcement Learning Framework for Public Health Decision Analysis.Healthcare analytics (New York, N.Y.) · 2025Article
- Data-Driven Dynamic Adjustment and Optimization Model of Emergency Logistics Network in Public Health.Risk management and healthcare policy · 2022Article
- Allocating treatment resources for hepatitis C in the UK: a constrained optimization modelling approach.Journal of market access & health policy · 2021Article
- Competing biomedical HIV prevention strategies: potential cost-effectiveness of HIV vaccines and PrEP in Seattle, WA.Journal of the International AIDS Society · 2019Article
- Population-level intervention and information collection in dynamic healthcare policy.Health care management science · 2018Article
- Treatment of Prolapsing Hemorrhoids in HIV-Infected Patients with Tissue-Selecting Technique.Gastroenterology research and practice · 2017Article
- Maximising HIV prevention by balancing the opportunities of today with the promises of tomorrow: a modelling study.The lancet. HIV · 2016Article
- Potential impact of pre-exposure prophylaxis for female sex workers and men who have sex with men in Bangalore, India: a mathematical modelling study.Journal of the International AIDS Society · 2016Article
- Initiation versus Cessation Control Policies: Deriving Optimal Resource Allocation Strategies to Decrease Smoking Prevalence Under a Fixed Budget.MDM policy & practiceArticle
- Constrained Optimization for Decision Making in Health Care Using Python: A Tutorial.Medical decision making : an international journal of the Society for Medical Decision MakingArticle
Corrections and comments
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Authors and funding
2 authors.
Funding
Abstract
objectiveTo create a simple model to help public health decision makers determine how to best invest limited resources in HIV treatment scale-up and prevention.
methodA linear model was developed for determining the optimal mix of investment in HIV treatment and prevention, given a fixed budget. The model incorporates estimates of secondary health benefits accruing from HIV treatment and prevention and allows for diseconomies of scale in program costs and subadditive benefits from concurrent program implementation. Data sources were published literature. The target population was individuals infected with HIV or at risk of acquiring it. Illustrative examples of interventions include preexposure prophylaxis (PrEP), community-based education (CBE), and antiretroviral therapy (ART) for men who have sex with men (MSM) in the US. Outcome measures were incremental cost, quality-adjusted life-years gained, and HIV infections averted.
resultsBase case analysis indicated that it is optimal to invest in ART before PrEP and to invest in CBE before scaling up ART. Diseconomies of scale reduced the optimal investment level. Subadditivity of benefits did not affect the optimal allocation for relatively low implementation levels. The sensitivity analysis indicated that investment in ART before PrEP was optimal in all scenarios tested. Investment in ART before CBE became optimal when CBE reduced risky behavior by 4% or less. Limitations of the study are that dynamic effects are approximated with a static model.
conclusionsOur model provides a simple yet accurate means of determining optimal investment in HIV prevention and treatment. For MSM in the US, HIV control funds should be prioritized on inexpensive, effective programs like CBE, then on ART scale-up, with only minimal investment in PrEP.
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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.