Optimal Allocation of Societal HIV Prevention Resources to Reduce HIV Incidence in the United States

Dados Bibliográficos

ID11019277
AutoresStephanie L Sansom (Stephanie L. Sansom, Evin U. Jacobson, Ram K. Shrestha, Timothy A. Green, and David W. Purcell are with the Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Katherine A. Hicks and Justin Carrico are with RTI Health Solutions, Raleigh, NC.), Katherine A Hicks (0000-0002-1058-3401, Stephanie L. Sansom, Evin U. Jacobson, Ram K. Shrestha, Timothy A. Green, and David W. Purcell are with the Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Katherine A. Hicks and Justin Carrico are with RTI Health Solutions, Raleigh, NC.), Justin Carrico (0000-0002-4659-9309, Stephanie L. Sansom, Evin U. Jacobson, Ram K. Shrestha, Timothy A. Green, and David W. Purcell are with the Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Katherine A. Hicks and Justin Carrico are with RTI Health Solutions, Raleigh, NC.), Evin Uzun Jacobson (0000-0002-7052-5633, Centers for Disease Control and Prevention), Ram K Shrestha (0000-0002-2812-8933, Stephanie L. Sansom, Evin U. Jacobson, Ram K. Shrestha, Timothy A. Green, and David W. Purcell are with the Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Katherine A. Hicks and Justin Carrico are with RTI Health Solutions, Raleigh, NC.), Timothy A Green (Stephanie L. Sansom, Evin U. Jacobson, Ram K. Shrestha, Timothy A. Green, and David W. Purcell are with the Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Katherine A. Hicks and Justin Carrico are with RTI Health Solutions, Raleigh, NC.), David W Purcell (0000-0001-8125-5168, Stephanie L. Sansom, Evin U. Jacobson, Ram K. Shrestha, Timothy A. Green, and David W. Purcell are with the Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Katherine A. Hicks and Justin Carrico are with RTI Health Solutions, Raleigh, NC.)
Ano2021
Volume111
Fascículo1
Páginas150-158
Data de publicação2021-01-01
Peer ReviewedSim
Open AccessNão
TipoARTICLE
PeriódicoAmerican Journal of Public Health (JOURNAL)
Identificadores do periódicoISSN: 0090-0036 • E-ISSN: 1541-0048
EditoraAmerican Public Health Association (PUBLISHER • US)
DOI10.2105/ajph.2020.305965
PMID33211582
OpenAlexW3102352269
IdiomaEN
Citações recebidas1
Referências citadas20

Objectives. To optimize combined public and private spending on HIV prevention to achieve maximum reductions in incidence. Methods. We used a national HIV model to estimate new infections from 2018 to 2027 in the United States. We estimated current spending on HIV screening, interventions that move persons with diagnosed HIV along the HIV care continuum, pre-exposure prophylaxis, and syringe services programs. We compared the current funding allocation with 2 optimal scenarios: (1) a limited-reach scenario with expanded efforts to serve eligible persons and (2) an ideal, unlimited-reach scenario in which all eligible persons could be served. Results. A continuation of the current allocation projects 331 000 new HIV cases over the next 10 years. The limited-reach scenario reduces that number by 69%, and the unlimited reach scenario by 94%. The most efficient funding allocations resulted in prompt diagnosis and sustained viral suppression through improved screening of high-risk persons and treatment adherence support for those infected. Conclusions. Optimal allocations of public and private funds for HIV prevention can achieve substantial reductions in new infections. Achieving reductions of more than 90% under current funding will require that virtually all infected receive sustained treatment

Business · Environmental health · Family medicine · Human immunodeficiency virus (HIV) · Incidence (geometry) · Psychological intervention · Public health · HIV, Drug Use, Sexual Risk · HIV/AIDS Research and Interventions · Medicine · Nursing · Sex work and related issues