Increasing survival time decreases the cost-effectiveness of using &quot;test &amp; treat to eliminate HIV epidemics

Bradley G. Wagner; Brian J. Coburn; Sally Blower; Bradley G. Wagner; Brian J. Coburn; Sally Blower

doi:10.3934/mbe.2013.10.1673

Mathematical Biosciences and Engineering

2013, Volume 10, Issue 5&6: 1673-1686. doi: 10.3934/mbe.2013.10.1673

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Increasing survival time decreases the cost-effectiveness of using "test & treat to eliminate HIV epidemics

1.
Center for Biomedical Modeling, Semel Institute of Neuroscience & Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, 10940 Wilshire Blvd, Suite 1450, Los Angeles, CA 90024

Received: 01 November 2012 Accepted: 29 June 2018 Published: 01 August 2013
MSC : Primary: 92D30, 92C60; Secondary: 92C50.

Treating HIV-infected individuals reduces their viral load, consequently increasing their survival time and decreasing their infectivity.It has been proposed that universal testing and treatment (i.e., universal ``test & treat'') could lead to HIV elimination and would be extremely cost-effective.It is now being debated whether to use a universal ``test and treat'' approach in the ``real-world'' as a prevention strategy to control HIV epidemics.However current modeling predictions of the impact, and cost-effectiveness, of universal ``test & treat'' strategies are based on an unrealistically short survival time for treated individuals.Here we use mathematical modeling and a longer, more realistic, survival time.We model the potential impact of a universal ``test & treat'' strategy in South Africa.Our results show that increasing the length of the survival time on treatment, although beneficial to individuals, reduces the probability of eliminating HIV and decreases the cost-effectiveness of using universal ``test & treat'' strategies.Therefore our results show that individual-level benefits and public health benefits will conflict when using ``test & treat'' strategies to reduce HIV transmission.

Keywords:

Citation: Bradley G. Wagner, Brian J. Coburn, Sally Blower. Increasing survival time decreases the cost-effectiveness of using "test & treat to eliminate HIV epidemics[J]. Mathematical Biosciences and Engineering, 2013, 10(5&6): 1673-1686. doi: 10.3934/mbe.2013.10.1673

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Abstract

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This article has been cited by:

V Cambiano, J O’Connor, A N Phillips, A Rodger, R Lodwick, A Pharris, F Lampe, F Nakagawa, C Smith, M J van de Laar , Antiretroviral therapy for prevention of HIV transmission: implications for Europe, 2013, 18, 1560-7917, 10.2807/1560-7917.ES2013.18.48.20647

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