• Behrends, Czarina N.
• Shoptaw, Steven
• Chen, Siyuan
• Study, Localized Hiv Modeling
• Mermin, Jonathan
• Krebs, Emanuel
• Schackman, Bruce
• Mehta, Shruti H.
• Marshall, Brandon D. L.
• Metsch, Lisa R.
• Nosyk, Bohdan
• Feaster, Daniel J.
• Strathdee, Steffanie A.
• Piske, Micah
• Armstrong, Wendy S.
• Zang, Xiao
• Rio, Carlos Del
• Kirk, Gregory
• Dombrowski, Julia C.
• Gebo, Kelly A.
• Pandya, Ankur
• Montaner, Julio

Abstract

<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>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.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>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.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>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.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>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.</jats:p></jats:sec>

Topics

• impedance spectroscopy
• size-exclusion chromatography