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The Potential Epidemiological Impact of Coronavirus Disease 2019 (COVID-19) on the Human Immunodeficiency Virus (HIV) Epidemic and the Cost-effectiveness of Linked, Opt-out HIV Testing: A Modeling Study in 6 US Cities
- Source :
- Clinical Infectious Diseases
- Publication Year :
- 2020
- Publisher :
- Oxford University Press (OUP), 2020.
-
Abstract
- Background Widespread viral and serological testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may present a unique opportunity to also test for human immunodeficiency virus (HIV) infection. We estimated the potential impact of adding linked, opt-out HIV testing alongside SARS-CoV-2 testing on the HIV incidence and the cost-effectiveness of this strategy in 6 US cities. Methods Using a previously calibrated dynamic HIV transmission model, we constructed 3 sets of scenarios for each city: (1) sustained current levels of HIV-related treatment and prevention services (status quo); (2) temporary disruptions in health services and changes in sexual and injection risk behaviors at discrete levels between 0%–50%; and (3) linked HIV and SARS-CoV-2 testing offered to 10%–90% of the adult population in addition to Scenario 2. We estimated the cumulative number of HIV infections between 2020–2025 and the incremental cost-effectiveness ratios of linked HIV testing over 20 years. Results In the absence of linked, opt-out HIV testing, we estimated a total of a 16.5% decrease in HIV infections between 2020–2025 in the best-case scenario (50% reduction in risk behaviors and no service disruptions), and a 9.0% increase in the worst-case scenario (no behavioral change and 50% reduction in service access). We estimated that HIV testing (offered at 10%–90% levels) could avert a total of 576–7225 (1.6%–17.2%) new infections. The intervention would require an initial investment of $20.6M–$220.7M across cities; however, the intervention would ultimately result in savings in health-care costs in each city. Conclusions A campaign in which HIV testing is linked with SARS-CoV-2 testing could substantially reduce the HIV incidence and reduce direct and indirect health care costs attributable to HIV.
- Subjects :
- Microbiology (medical)
medicine.medical_specialty
030505 public health
Cost–benefit analysis
Coronavirus disease 2019 (COVID-19)
Cost effectiveness
business.industry
Human immunodeficiency virus (HIV)
virus diseases
Hiv testing
medicine.disease_cause
Opt-out
03 medical and health sciences
0302 clinical medicine
Infectious Diseases
Environmental health
Epidemiology
Health care
medicine
030212 general & internal medicine
0305 other medical science
business
Subjects
Details
- Language :
- English
- ISSN :
- 15376591 and 10584838
- Database :
- OpenAIRE
- Journal :
- Clinical Infectious Diseases
- Accession number :
- edsair.doi.dedup.....57f3c874733a39b3748143aa91196f2b
- Full Text :
- https://doi.org/10.1093/cid/ciaa1547