ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2024
Projecting the Potential Clinical and Economic Impact of HIV Prevention Resource Reallocation in Tennessee.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
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Who cites it
5 citing papers in PubMed, 1 synthesis or guideline 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
- Clinical Consequences of Delaying Implementation of Long-Acting Antiretroviral Therapy for People With HIV and Persistent Viremia in the United States.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- Implementing Social Media Strategies in Community-Partnered HIV Research: Practical Considerations From 3 Ongoing Studies.JMIR public health and surveillance · 2025Article
- Three Drugs, Two Pills, One Algorithm: A Cross-Sectional Pilot Study of Consolidated Guidelines for HIV PrEP, PEP, and Treatment Initiation for Resource-Limited and Non-specialty Settings in the United States.Journal of the International Association of Providers of AIDS CareArticle
- Leveraging Explainable AI to Identify Determinants of Lifetime HIV Testing Among Adults in Tennessee, United States: Evidence for Targeted Public Health Strategies From BRFSS 2023.Journal of primary care & community healthArticle
Corrections and comments
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Authors and funding
19 authors.
Funding
Abstract
backgroundIn 2023, Tennessee replaced $6.2 M in US Centers for Disease Control and Prevention (CDC) human immunodeficiency virus (HIV) prevention funding with state funds to redirect support away from men who have sex with men (MSM), transgender women (TGW), and heterosexual Black women (HSBW) and to prioritize instead first responders (FR), pregnant people (PP), and survivors of sex trafficking (SST).
methodsWe used a simulation model of HIV disease to compare the clinical impact of Current, the present allocation of condoms, preexposure prophylaxis (PrEP), and HIV testing to CDC priority risk groups (MSM/TGW/HSBW); with Reallocation, funding instead increased HIV testing and linkage of Tennessee-determined priority populations (FR/PP/SST). Key model inputs included baseline condom use (45%-49%), PrEP provision (0.1%-8%), HIV testing frequency (every 2.5-4.8 years), and 30-day HIV care linkage (57%-65%). We assumed Reallocation would reduce condom use (-4%), PrEP provision (-26%), and HIV testing (-47%) in MSM/TGW/HSBW, whereas it would increase HIV testing among FR (+47%) and HIV care linkage (to 100%/90%) among PP/SST.
resultsReallocation would lead to 166 additional HIV transmissions, 190 additional deaths, and 843 life-years lost over 10 years. HIV testing reductions were most influential in sensitivity analysis; even a 24% reduction would result in 287 more deaths compared to Current. With pessimistic assumptions, we projected 1359 additional HIV transmissions, 712 additional deaths, and 2778 life-years lost over 10 years.
conclusionsRedirecting HIV prevention funding in Tennessee would greatly harm CDC priority populations while conferring minimal benefits to new priority populations.
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