ArticleAIDS (London, England)2020
The impact of localized implementation: determining the cost-effectiveness of HIV prevention and care interventions across six United States cities.
Article in AIDS (London, England), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
31 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
- Cost-Effectiveness of HIV Retention and Re-engagement Interventions in High-Income Countries: A Systematic Literature Review.AIDS and behavior · 2022Pooled it
- What Tools Do We Have to End the US HIV Epidemic? A Review of Structural, Biomedical and Implementation Interventions and Their Potential Population Impact.Journal of the International AIDS Society · 2026Review
- "It's Our Superpower": A Mixed-Methods Study to Understand Motivation and Capabilities for HIV Management Among African American/Black and Latine Emerging Adults Living With HIV.AIDS and behavior · 2026Article
- Establish a PrEP (Pre-Exposure Prophylaxis) Epidemiology, Modeling, and Surveillance (PREMISE) System to Analyze Trends in PrEP Uptake and the Impact of PrEP Programs and Policies: Protocol for a Natural Experiment and Modeling Study in the United States.JMIR research protocols · 2026Article
- Assessing the efficiency and effectiveness of community-based voluntary counseling and testing for HIV in Turin: insights from the fast-track cities initiative - a cross-sectional study.BMC health services research · 2025Article
- National Hospitalization Rates and In-Hospital Mortality Rates of HIV-Related Opportunistic Infections in the United States, 2011-2018.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Article
- 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.Journal of the International AIDS Society · 2024Article
- Rapid initiation of antiretroviral therapy in Turkey: a modeling study.Frontiers in public health · 2024Article
- Translating and disseminating a localised economic model to support implementation of the 'Ending the HIV Epidemic' initiative to public health policymakers.Evidence & policy : a journal of research, debate and practice · 2023Article
- Estimating the epidemiological impact of reaching the objectives of the Florida integrated HIV prevention and care plan in Miami-Dade County.Lancet regional health. Americas · 2023Article
- The Testing Imperative: Why the US Ending the Human Immunodeficiency Virus (HIV) Epidemic Program Needs to Renew Efforts to Expand HIV Testing in Clinical and Community-Based Settings.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Article
- The effects of COVID-19 on New York State's Drug User Health Hubs and syringe service programs: a qualitative study.Harm reduction journal · 2023Article
- Reply.Journal of acquired immune deficiency syndromes (1999) · 2022Article
- Highlighting the need for investment and innovation in ART retention interventions.The Lancet. Global health · 2022Article
- The Impact of Churn on HIV Outcomes in a Southern United States Clinical Cohort.Open forum infectious diseases · 2022Article
- Article
- Vital Signs: HIV Infection, Diagnosis, Treatment, and Prevention Among Gay, Bisexual, and Other Men Who Have Sex with Men - United States, 2010-2019.MMWR. Morbidity and mortality weekly report · 2021Article
- Improving health equity and ending the HIV epidemic in the USA: a distributional cost-effectiveness analysis in six cities.The lancet. HIV · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
17 authors.
Funding
Abstract
objectiveEffective interventions to reduce the public health burden of HIV/AIDS can vary in their ability to deliver value at different levels of scale and in different epidemiological contexts. Our objective was to determine the cost-effectiveness of HIV treatment and prevention interventions implemented at previously documented scales of delivery in six US cities with diverse HIV microepidemics.
designDynamic HIV transmission model-based cost-effectiveness analysis.
methodsWe identified and estimated previously documented scale of delivery and costs for 16 evidence-based interventions from the US CDC's Compendium of Evidence-Based Interventions and Best Practices for HIV Prevention. Using a model calibrated for Atlanta, Baltimore, Los Angeles, Miami, New York City and Seattle, we estimated averted HIV infections, quality-adjusted life years (QALY) gained and incremental cost-effectiveness ratios (healthcare perspective; 3% discount rate, 2018$US), for each intervention and city (10-year implementation) compared with the status quo over a 20-year time horizon.
resultsIncreased HIV testing was cost-saving or cost-effective across cities. Targeted preexposure prophylaxis for high-risk MSM was cost-saving in Miami and cost-effective in Atlanta ($6123/QALY), Baltimore ($18 333/QALY) and Los Angeles ($86 117/QALY). Interventions designed to improve antiretroviral therapy initiation provided greater value than other treatment engagement interventions. No single intervention was projected to reduce HIV incidence by more than 10.1% in any city.
conclusionCombination implementation strategies should be tailored to local epidemiological contexts to provide the most value. Complementary strategies addressing factors hindering access to HIV care will be necessary to meet targets for HIV elimination in the United States.
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Registered trials
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