ArticleThe lancet. HIV2020
Ending the HIV epidemic in the USA: an economic modelling study in six cities.
Article in The lancet. HIV, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 2 of them syntheses that pooled it.
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Who cites it
37 citing papers in PubMed, 2 syntheses or guidelines pooled it, 65 citations in OpenAlex.
- 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
- Cost-Effectiveness of HIV Retention and Re-engagement Interventions in High-Income Countries: A Systematic Literature Review.AIDS and behavior · 2022Pooled it
- Ending the HIV Epidemic in the United States Among Men Who Have Sex With Men: A Modeling Analysis.Open forum infectious diseases · 2026Article
- Using a Syringe Service Program-Based Community Advisory Board to Expand HIV Testing, Overdose Prevention, and PrEP Linkage in a Southern Black Neighborhood.Journal of racial and ethnic health disparities · 2026Article
- Multidimensional Trends and AI-Based Forecasts of HIV Incidence in Korea, 1985-2024.Journal of epidemiology and global health · 2026Article
- Untangling the Web of Hepatitis C Risk in Rural Communities.Journal of general internal medicine · 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
- HIV case management using agent-based modeling approach subject to antiretroviral therapy and lifestyle treatment plan.Scientific reports · 2025Article
- Characterization of Antiretroviral Therapy (ART) Adherence Phenotypes and Psychosocial Symptom Clusters Among Black/African American (AA) and Hispanic/Latine Adolescents and Young Adults (AYAs) with HIV in the Adherence Connection for Counseling, Education, and Support (ACCESS-II) Trial.Tropical medicine and infectious disease · 2025Article
- A modeling study of pre-exposure prophylaxis to eliminate HIV in Taiwan by 2030.Communications medicine · 2025Article
- St. Louis enhancing engagement and retention (STEER) in HIV/AIDS care: a participatory intersectional needs assessment for intervention and implementation planning.Frontiers in public health · 2025Article
- Ending the HIV Epidemic in Metropolitan Atlanta: a mixed-methods study to support the local HIV/AIDS response.Journal of the International AIDS Society · 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
- PrEP and Behavioral Health Treatment Referral Among HIV Test Counselors in Miami-Dade County: A Rapid Qualitative Study Using the Consolidated Framework for Implementation Research.AIDS and behavior · 2024Article
- AIDSVu Cities' Progress Toward HIV Care Continuum Goals: Cross-Sectional Study.JMIR public health and surveillance · 2024Article
- A commentary on forging a path for CHANGE: culturally focused HIV training for the next generation in pursuit of equity.Critical public health · 2024Article
- 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
- 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
- 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
- Evaluating the sensitivity of jurisdictional heterogeneity and jurisdictional mixing in national level HIV prevention analyses: context of the U.S. ending the HIV epidemic plan.BMC medical research methodology · 2022Article
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Authors and funding
18 authors at 12 institutions in 2 countries.
Funding
Abstract
backgroundThe HIV epidemic in the USA is a collection of diverse local microepidemics. We aimed to identify optimal combination implementation strategies of evidence-based interventions to reach 90% reduction of incidence in 10 years, in six US cities that comprise 24·1% of people living with HIV in the USA.
methodsIn this economic modelling study, we used a dynamic HIV transmission model calibrated with the best available evidence on epidemiological and structural conditions for six US cities: Atlanta (GA), Baltimore (MD), Los Angeles (CA), Miami (FL), New York City (NY), and Seattle (WA). We assessed 23 040 combinations of 16 evidence-based interventions (ie, HIV prevention, testing, treatment, engagement, and re-engagement) to identify combination strategies providing the greatest health benefit while remaining cost-effective. Main outcomes included averted HIV infections, quality-adjusted life-years (QALYs), total cost (in 2018 US$), and incremental cost-effectiveness ratio (ICER; from the health-care sector perspective, 3% annual discount rate). Interventions were implemented at previously documented and ideal (90% coverage or adoption) scale-up, and sustained from 2020 to 2030, with outcomes evaluated until 2040.
findingsOptimal combination strategies providing health benefit and cost-effectiveness contained between nine (Seattle) and 13 (Miami) individual interventions. If implemented at previously documented scale-up, these strategies could reduce incidence by between 30·7% (95% credible interval 19·1-43·7; Seattle) and 50·1% (41·5-58·0; New York City) by 2030, at ICERs ranging from cost-saving in Atlanta, Baltimore, and Miami, to $95 416 per QALY in Seattle. Incidence reductions reached between 39·5% (26·3-53·8) in Seattle and 83·6% (70·8-87·0) in Baltimore at ideal implementation. Total costs of implementing strategies across the cities at previously documented scale-up reached $559 million per year in 2024; however, costs were offset by long-term reductions in new infections and delayed disease progression, with Atlanta, Baltimore, and Miami projecting cost savings over the 20 year study period.
interpretationEvidence-based interventions can deliver substantial public health and economic value; however, complementary strategies to overcome social and structural barriers to HIV care will be required to reach national targets of the ending the HIV epidemic initiative by 2030.
fundingNational Institutes of Health.
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