ArticleEClinicalMedicine2020
Modeling the health impact and cost threshold of long-acting ART for adolescents and young adults in Kenya.
Article in EClinicalMedicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.
- Evidence Gaps in Economic Evaluations of HIV Interventions Targeting Young People: A Systematic Review.The Journal of adolescent health : official publication of the Society for Adolescent Medicine · 2024Pooled it
- Cost-Effectiveness of an Enhanced Patient Care Intervention for Improving Viral Suppression Among Kenyan Adults Living With HIV.Value in health regional issues · 2025Trial
- Patient preferences for long-acting antiretroviral treatment among people with HIV in Kenya: a discrete choice experiment.BMC infectious diseases · 2026Article
- Cost-Effectiveness Analyses of Adolescent- and Young-Adult-Focused HIV Interventions Incorporating HIV Transmission: a Scoping Review of Modeling Methods and Proposed Guidance.PharmacoEconomics - open · 2025Review
- Cost-effectiveness of long-acting cabotegravir/rilpivirine for people with HIV and adherence challenges at the Ward 86 clinic: an intermediate outcome analysis.AIDS (London, England) · 2025Article
- Bridging the gap: identifying barriers and strategies for widespread implementation of long-acting injectable antiretroviral therapy in Sub-Saharan Africa: a scoping review.BMC infectious diseases · 2025Article
- Barriers and facilitators to equitable implementation of long-acting ART for adolescents and youth with HIV in low- and middle-income settings.The Pan African medical journal · 2024Article
- Factors Associated with Preferences for Long-Acting Injectable Antiretroviral Therapy Among Adolescents and Young People Living with HIV in South Africa.AIDS and behavior · 2023Article
- High Acceptability and Perceived Feasibility of Long-Acting Injectable Antiretroviral Treatment Among People Living with HIV Who Are Viremic and Health Workers in Uganda.AIDS patient care and STDs · 2023Article
- Prevalence and Correlates of Viral Load Suppression and Human Immunodeficiency Virus (HIV) Drug Resistance Among Children and Adolescents in South Rift Valley and Kisumu, Kenya.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Article
- Long-Acting Injectable Antiretroviral Agents for HIV Treatment and Prevention.Infection & chemotherapy · 2021Review
- Modeling Adherence Interventions Among Youth with HIV in the United States: Clinical and Economic Projections.AIDS and behavior · 2021Article
- The potential role of long-acting injectable cabotegravir-rilpivirine in the treatment of HIV in sub-Saharan Africa: a modelling analysis.The Lancet. Global health · 2021Article
- Stakeholder Perspectives on the Role of Peer Mentors in the Implementation of Long-Acting Antiretroviral Therapy for Use by Adolescents and Young People in Western Kenya: Findings from a Formative Study, KuwaFree! LiveFree!Journal of the International Association of Providers of AIDS CareArticle
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundDespite high efficacy of oral antiretroviral therapy (ART), viral suppression among adolescents and young adults (AYA) living with HIV in sub-Saharan Africa (SSA) remains low. Compared to daily oral ART, bimonthly long-acting injectable ART (LA-ART) may simplify adherence, improve clinical outcomes, and decrease HIV transmission in this priority population. However, LA-ART will likely cost more than oral ART and the cost threshold at which LA-ART will be cost effective in SSA has not been evaluated.
methodsWe adapted a mathematical model of HIV transmission and progression in Kenya to include HIV acquisition and viral suppression among AYA (age 10-24). We projected the population-level health and economic impact of providing LA-ART to AYA over a 10-year time horizon assuming oral ART costs of US$233 annually and a two-month duration of viral suppression per LA-ART injection. We calculated the maximum cost at which switching from oral to LA-ART would be considered cost-effective, using thresholds of $500 and $1,508 per disability-adjusted life year averted (WHO's threshold of HIV treatment interventions and Kenya's gross domestic product per capita).
findingsAssuming 85% of AYA switch from oral to injectable formulations, LA-ART is estimated to prevent 40,540 infections and 20,480 deaths over 10 years. The maximum increase in the annual per-person cost of receiving LA-ART is estimated to be $89 and $236 for LA-ART to be cost-effective under the thresholds of $500 and $1,508 per DALY averted, respectively. The cost threshold was lower when non-adherent oral ART AYA users were assumed to be less likely to switch to LA-ART.
interpretationProviding LA-ART to AYA can be cost-effective in Kenya if it is less than twice the cost of oral ART. Long-acting injectable ART for priority populations with low viral suppression has the potential to cost-effectively avert disability and death.
fundingNational Institutes of Health (R01 HD085807; PI: Kohler).
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Registered trials
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