ArticleJournal of acquired immune deficiency syndromes (1999)2022
Cost-Effectiveness of Interventions to Improve HIV Pre-exposure Prophylaxis Initiation, Adherence, and Persistence Among Men Who Have Sex With Men.
Article in Journal of acquired immune deficiency syndromes (1999), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 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
7 citing papers in PubMed, 3 syntheses or guidelines pooled it, 7 citations in OpenAlex.
- Prospects of HIV elimination among men who have sex with men: A systematic review of modeling studies.PLoS computational biology · 2026Pooled 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 Review of Network Models for HIV Spread.Journal of acquired immune deficiency syndromes (1999) · 2025Pooled it
- Impact of a point-of-care urine tenofovir assay on adherence to HIV pre-exposure prophylaxis among women in Kenya: a randomised pilot trial.The lancet. HIV · 2024Trial
- A Multi-Agent Reinforcement Learning Framework for Public Health Decision Analysis.Healthcare analytics (New York, N.Y.) · 2025Article
- Meta-Modeling as a Variance-Reduction Technique for Stochastic Model-Based Cost-Effectiveness Analyses.Medical decision making : an international journal of the Society for Medical Decision Making · 2025Article
- Excess HIV Infections and Costs Associated With Reductions in HIV Prevention Services in the US.JAMA network open · 2025Article
Corrections and comments
- Commented on byReply.2022
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundTo help achieve Ending the HIV Epidemic (EHE) goals of reducing new HIV incidence, pre-exposure prophylaxis (PrEP) use and engagement must increase despite multidimensional barriers to scale-up and limitations in funding. We investigated the cost-effectiveness of interventions spanning the PrEP continuum of care.
settingMen who have sex with men in Atlanta, GA, a focal jurisdiction for the EHE plan.
methodsUsing a network-based HIV transmission model, we simulated lifetime costs, quality-adjusted life years (QALYs), and infections averted for 8 intervention strategies using a health sector perspective. Strategies included a status quo (no interventions), 3 distinct interventions (targeting PrEP initiation, adherence, or persistence), and all possible intervention combinations. Cost-effectiveness was evaluated incrementally using a $100,000/QALY gained threshold. We performed sensitivity analyses on PrEP costs, intervention costs, and intervention coverage.
resultsStrategies averted 0.2%-4.2% new infections and gained 0.0045%-0.24% QALYs compared with the status quo. Initiation strategies achieved 20%-23% PrEP coverage (up from 15% with no interventions) and moderate clinical benefits at a high cost, while adherence strategies were relatively low cost and low benefit. Under our assumptions, the adherence and initiation combination strategy was cost-effective ($86,927/QALY gained). Sensitivity analyses showed no strategies were cost-effective when intervention costs increased by 60% and the strategy combining all 3 interventions was cost-effective when PrEP costs decreased to $1000/month.
conclusionPrEP initiation interventions achieved moderate public health gains and could be cost-effective. However, substantial financial resources would be needed to improve the PrEP care continuum toward meeting EHE goals.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.