THAB0302 - Oral Abstract Session
Cost-effectiveness of more frequent HIV screening of men who have sex with men in the United States
Presented by Angela Hutchinson (United States).
A. Hutchinson, S. Sansom, P. Farnham
Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Atlanta, United States
Background: Recent data showing a high incidence of HIV infection among men who have sex with men (MSM) who had been tested during the past year suggest that MSM might benefit from more frequent HIV screening (e.g., every 3 to 6 months). We assessed the cost-effectiveness of HIV screening at 3 and 6 month intervals compared with annual screening.
Methods: We used a published mathematical model of HIV transmission to evaluate screening intervals for a cohort of 10,000 MSM ages 14-64. We incorporated HIV transmissions averted due to serostatus awareness for each screening interval (e.g. 3, 6, 12 months), as well as HIV testing costs and treatment costs for averted transmissions. We assumed an HIV incidence of 1.27% for MSM and conducted threshold analyses on incidence. We assumed conventional testing with a 3rd generation antibody test and 75% receipt of results. In sensitivity analyses, we investigated the impact of all rapid testing and 100% receipt of results. We valued each HIV transmission averted using lifetime treatment costs of $367,134.
Results: Compared to annual screening, conventional HIV testing every 3 months and 6 months averted 2.04 and 1.36 HIV transmissions, respectively, and both were cost-saving. The incremental cost-effectiveness of 3-month versus 6-month screening also was cost-saving. Threshold values for HIV incidence at which screening was cost-saving were 0.3% and 0.5% at the 3-month and 6-month screening intervals, respectively. Screening with a rapid test was cost-saving at both 3- and 6-month intervals compared to annual screening. The incremental cost-effectiveness of 3-month versus 6-month screening was $813 per QALY saved.
[Cost-effectiveness of HIV Screening for MSM]
| ||Every 6 months compared to annually||Every 3 months compared to annually||Every 3 months compared to every 6 months|
|HIV Screening Costs||$97,340||$284,574||$187,233|
|HIV Transmissions Averted||1.36||2.04||0.68|
|HIV Treatment Costs Saved||$500,149||$750,223||$250,074|
|Incremental Cost-effectiveness Ratio||Cost-saving||Cost-saving||Cost-saving|
Conclusions: HIV screening with either conventional or rapid testing as frequently as every 3 months is cost-saving or very cost-effective. Reexamination of HIV screening intervals for MSM should be considered on the basis of the economic evidence.
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