PMID- 29135654
OWN - NLM
STAT- In-Data-Review
LR  - 20180206
IS  - 1944-7884 (Electronic)
IS  - 1525-4135 (Linking)
VI  - 77
IP  - 2
DP  - 2018 Feb 1
TI  - Cost-Effectiveness of Peer- Versus Venue-Based Approaches for Detecting
      Undiagnosed HIV Among Heterosexuals in High-Risk New York City Neighborhoods.
PG  - 183-192
LID - 10.1097/QAI.0000000000001578 [doi]
AB  - INTRODUCTION: We used a computer simulation of HIV progression and transmission
      to evaluate the cost-effectiveness of a scale-up of 3 strategies to seek out and 
      test individuals with undiagnosed HIV in New York City (NYC). SETTING:
      Hypothetical NYC population. METHODS: We incorporated the observed effects and
      costs of the 3 "seek and test" strategies in a computer simulation of HIV in NYC,
      comparing a scenario in which the strategies were scaled up with a 1-year
      implementation or a long-term implementation with a counterfactual scenario with 
      no scale-up. The simulation combined a deterministic compartmental model of HIV
      transmission with a stochastic microsimulation of HIV progression, calibrated to 
      NYC epidemiological data from 2003 to 2015. The 3 approaches were
      respondent-driven sampling (RDS) with anonymous HIV testing ("RDS-A"), RDS with a
      2-session confidential HIV testing approach ("RDS-C"), and venue-based sampling
      ("VBS"). RESULTS: RDS-A was the most cost-effective strategy tested. When
      implemented for only 1 year and then stopped thereafter, using a societal
      perspective, the cost per quality-adjusted life-year (QALY) gained versus no
      intervention was $812/QALY, $18,110/QALY, and $20,362/QALY for RDS-A, RDS-C, and 
      VBS, respectively. When interventions were implemented long term, the cost per
      QALY gained versus no intervention was cost-saving, $31,773/QALY, and
      $35,148/QALY for RDS-A, RDS-C, and VBS, respectively. When compared with RDS-A,
      the incremental cost-effectiveness ratios for both VBS and RDS-C were dominated. 
      CONCLUSIONS: The expansion of the RDS-A strategy would substantially reduce
      HIV-related deaths and new HIV infections in NYC, and would be either cost-saving
      or have favorable cost-effectiveness.
FAU - Stevens, Elizabeth R
AU  - Stevens ER
AD  - Department of Population Health, NYU School of Medicine, New York, NY.
FAU - Nucifora, Kimberly A
AU  - Nucifora KA
AD  - Department of Population Health, NYU School of Medicine, New York, NY.
FAU - Zhou, Qinlian
AU  - Zhou Q
AD  - Department of Population Health, NYU School of Medicine, New York, NY.
FAU - Braithwaite, Ronald Scott
AU  - Braithwaite RS
AD  - Department of Population Health, NYU School of Medicine, New York, NY.
FAU - Cleland, Charles M
AU  - Cleland CM
AD  - Center for Drug Use and HIV Research, Rory Meyers College of Nursing, New York
      University, New York, NY.
FAU - Ritchie, Amanda S
AU  - Ritchie AS
AD  - Center for Drug Use and HIV Research, Rory Meyers College of Nursing, New York
      University, New York, NY.
FAU - Kutnick, Alexandra H
AU  - Kutnick AH
AD  - Center for Drug Use and HIV Research, Rory Meyers College of Nursing, New York
      University, New York, NY.
FAU - Gwadz, Marya V
AU  - Gwadz MV
AD  - Center for Drug Use and HIV Research, Rory Meyers College of Nursing, New York
      University, New York, NY.
LA  - eng
GR  - P30 DA011041/DA/NIDA NIH HHS/United States
GR  - R01 DA032083/DA/NIDA NIH HHS/United States
GR  - T32 DA007233/DA/NIDA NIH HHS/United States
PT  - Journal Article
PL  - United States
TA  - J Acquir Immune Defic Syndr
JT  - Journal of acquired immune deficiency syndromes (1999)
JID - 100892005
PMC - PMC5762425
MID - NIHMS915703
EDAT- 2017/11/15 06:00
MHDA- 2017/11/15 06:00
CRDT- 2017/11/15 06:00
PMCR- 2019/02/01 00:00
PHST- 2019/02/01 00:00 [pmc-release]
PHST- 2017/11/15 06:00 [pubmed]
PHST- 2017/11/15 06:00 [medline]
PHST- 2017/11/15 06:00 [entrez]
AID - 10.1097/QAI.0000000000001578 [doi]
PST - ppublish
SO  - J Acquir Immune Defic Syndr. 2018 Feb 1;77(2):183-192. doi:
      10.1097/QAI.0000000000001578.