Evidence map›Paper›PMID 41351116›Full record

ArticleBMC health services research2025

Projecting lifetime HIV-related healthcare costs for youth with HIV in the United States.

Michelle L Jones, Sujata E Tewari, Joshua Espada, Kunjal Patel, Clare F Flanagan, Sarah E Rutstein, Allison L Agwu, Kenneth A Freedberg, Maria E Trent, John C Giardina and 3 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Michelle L Jones *Medical Practice Evaluation Center, Massachusetts General Hospital, 100 Cambridge Street 16th floor, Boston, MA, 02114, USA.
Sujata E Tewari *Medical Practice Evaluation Center, Massachusetts General Hospital, 100 Cambridge Street 16th floor, Boston, MA, 02114, USA.
Joshua EspadaInstitute on Digital Health and Innovation, Florida State University College of Nursing, Tallahassee, FL, USA.
Kunjal PatelDepartment of Epidemiology, Center for Biostatistics in AIDS Research, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Clare F FlanaganMedical Practice Evaluation Center, Massachusetts General Hospital, 100 Cambridge Street 16th floor, Boston, MA, 02114, USA.
Sarah E RutsteinDepartment of Internal Medicine, Division of Infectious Diseases, UNC School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Allison L AgwuDivision of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Kenneth A FreedbergMedical Practice Evaluation Center, Massachusetts General Hospital, 100 Cambridge Street 16th floor, Boston, MA, 02114, USA.
Maria E TrentDivision of Adolescent/Young Adult Medicine, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
John C GiardinaMedical Practice Evaluation Center, Massachusetts General Hospital, 100 Cambridge Street 16th floor, Boston, MA, 02114, USA.
Emily P HyleMedical Practice Evaluation Center, Massachusetts General Hospital, 100 Cambridge Street 16th floor, Boston, MA, 02114, USA.
Andrea L CiaranelloMedical Practice Evaluation Center, Massachusetts General Hospital, 100 Cambridge Street 16th floor, Boston, MA, 02114, USA.
Anne M NeilanMedical Practice Evaluation Center, Massachusetts General Hospital, 100 Cambridge Street 16th floor, Boston, MA, 02114, USA. aneilan@mgh.harvard.edu.

Funding

SDMC; Statistical Data Mgmt CoreUM2HD111102 · NICHD · FLORIDA STATE UNIVERSITY · PI Lisa B Hightow-Weidman, Sybil Hosek · 2023 to 2026
$49.7M
Adolescent-tailored HIV treatment and prevention strategies in South Africa: projecting clinical benefits and value (Supplement)R01HD111355 · NICHD · MASSACHUSETTS GENERAL HOSPITAL · PI Anne Neilan · 2022 to 2026
$4.8M
NICHD NIH HHS R01 HD111355NICHD NIH HHS UM2 HD111102
6 · The paper itself

Abstract

BACKGROUND AND

objectivesUS youth with HIV (YHIV) face challenges to antiretroviral therapy (ART) adherence and care engagement. Understanding YHIV healthcare costs is essential for healthcare payers and for evaluating the cost-effectiveness of youth-focused interventions.

methodsUsing the CEPAC-Adolescent microsimulation model, we simulated YHIV cohorts, including those with HIV acquired perinatally (15%) and non-perinatally (85%), aged 13-24 years, in care and prescribed ART. We projected undiscounted life expectancy from model start; per-person and population-level (n = 24,626) lifetime HIV-related healthcare costs (discounted at 3% annually) from a health payer perspective.

resultsYHIV were projected to live 47.4 life-years after model start, with discounted lifetime HIV-related healthcare costs of $685,000/person ($1,404,000/person undiscounted). Overall, this population would accrue $16.9 billion in discounted HIV-related care costs over their lifetimes. ART medication would comprise most costs (74%), followed by routine HIV-related clinical care (22%), which would be most costly during the time spent at low CD4 counts. ART prices were the most impactful input; generic prices could reduce total lifetime costs by 62% ($264,000/person discounted).

conclusionsWe projected that US YHIV in care aged 13-24 years would incur nearly $17 billion in lifetime HIV-related healthcare costs. While total costs would increase with improved HIV-related care due to longer life expectancy, monthly costs would be highest during time spent at lower CD4 counts. ART costs would drive lifetime HIV-related healthcare costs for YHIV. Efforts to decrease ART prices and interventions to improve HIV care engagement and support consistent ART use could reduce HIV care costs and improve health outcomes for YHIV.

Indexed as

Health Care CostsHIV InfectionsAdolescentCost-Benefit AnalysisFemaleHumansLife ExpectancyMaleUnited StatesYoung AdultAdolescentAntiretroviral therapyGeneric pricingHealthcare costsHIVYouth

Identifiers

PMID41351116
PMCPMC12797550

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

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.