Decreasing prevalence hides a high HIV incidence

Peterman, Thomas A.; Zaidi, Akbar A.; Wroten, Jack E.

doi:10.1097/00002030-199508000-00021

Cited by 30 publications

(9 citation statements)

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“…Precise values for annual probability of acquiring HIV were difficult to obtain. Our base case probability of acquiring HIV for the WINGSparticipants (0.019) was higher than suggested by the incidence rates reported in some studies of women at high risk for acquiring HIV (0.018 to 1.2 new infections per 100 person-years [23,24]), but substantially lower than others (3 or more new infections per 100 person-years [19-22]).…”

Section: Discussioncontrasting

confidence: 66%

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The cost-effectiveness of the WINGS intervention: a program to prevent HIV and sexually transmitted diseases among high-risk urban women

2002

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Abstract

Background

We evaluated the cost-effectiveness of the WINGS project, an intervention to prevent HIV and other sexually transmitted diseases among urban women at high risk for sexual acquisition of HIV.

Methods

We used standard methods of cost-effectiveness analysis. We conducted a retrospective analysis of the intervention's cost and we used a simplified model of HIV transmission to estimate the number of HIV infections averted by the intervention. We calculated cost-effectiveness ratios for the complete intervention and for the condom use skills component of the intervention.

Results

Under base case assumptions, the intervention prevented an estimated 0.2195 new cases of HIV at a cost of $215,690 per case of HIV averted. When indirect costs of HIV were excluded from the analysis, the intervention's cost-effectiveness ratios were $357,690 per case of HIV averted and $31,851 per quality-adjusted life year (QALY) saved. Under base case assumptions, the condom use skills component of the intervention prevented an estimated 0.1756 HIV infections and was cost-saving. When indirect HIV costs were excluded, the cost-effectiveness ratios for the condom use skills component of the intervention were $97,404 per case of HIV averted and $8,674 per QALY saved.

Conclusions

The WINGS intervention, particularly the two sessions of the intervention which focussed on condom use skills, could be cost-effective in preventing HIV among women.

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Section: Discussioncontrasting

confidence: 66%

“…The cost-effectiveness ratios improved substantially when we assumed an annual probability of acquiring HIV of 3% per year (Table 5), a probability consistent with HIV incidence rates in some populations of high-risk urban women [19-22]. …”

Section: Discussionmentioning

confidence: 99%

The cost-effectiveness of the WINGS intervention: a program to prevent HIV and sexually transmitted diseases among high-risk urban women

2002

View full text Add to dashboard Cite

Abstract

Background

We evaluated the cost-effectiveness of the WINGS project, an intervention to prevent HIV and other sexually transmitted diseases among urban women at high risk for sexual acquisition of HIV.

Methods

Results

Conclusions

The WINGS intervention, particularly the two sessions of the intervention which focussed on condom use skills, could be cost-effective in preventing HIV among women.

show abstract

“…In this study we focused on positivity as a proxy for prevalence, and therefore cannot infer incidence or changes in incidence. It has previously been suggested that a decrease in prevalence can mask stable or increasing incidence, 16 evident from studies in the Netherlands, 17 the United States, 15 and England. 18 There was marked heterogeneity among the seven participating laboratories in terms of case mix and prevalence.…”

Section: Discussionmentioning

confidence: 99%

Trends in, and determinants of, HIV testing at genitourinary medicine clinics and general practice in England, 1990-2000

Chadborn¹,

McGarrigle²,

Waight³

et al. 2004

Sexually Transmitted Infections

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“…We are seeking a proven public health professional who will share the national leadership of our association with strong volunteer leadership, as well as plan and direct the supporting activities of approximately 70 APHA staffpersons. Our Search Committee plans to present finalist candid,ates to the APHA Executive Board expeditiously.…”

Section: Apha Announces Search For Executive Directormentioning

confidence: 99%

The estimated prevalence and incidence of HIV in 96 large US metropolitan areas.

Holmberg¹

1996

Am J Public Health

518

219

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OBJECTIVES: This study sought to estimate the size and direction of the human immunodeficiency virus (HIV) epidemic in US metropolitan statistical areas (MSAs) with populations greater than 500,000. METHODS: A "components model" from review of more than 350 documents, several large datasets, and information from 220 public health personnel was used. Data review focused on injection drug users, men who have sex with men, and high-risk heterosexual men and women. RESULTS: In the 96 MSAs, there are, broadly, an estimated 1.5 million injection drug users, 1.7 million gay and bisexual men, and 2.1 million at-risk heterosexuals, and, among them, an estimated 565,000 prevalent and 38,000 incident HIV infections. This implies about 700,000 prevalent and 41,000 new HIV infections yearly in the United States. Roughly half of all estimated new infections are occurring among injection drug users, most of them in northeastern cities, Miami, and San Juan. Gay and bisexual men still represent most prevalent HIV infections, although incidence--except in young and minority gay men--is much lower now than it was a decade ago. Relatively high prevalences of HIV in at-risk heterosexual persons in several cities indicate the potential for an increase in transmission among them. CONCLUSIONS: This review and synthesis outline the comparative epidemiology of HIV in major US cities and identify populations for interventions.

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Decreasing prevalence hides a high HIV incidence

Cited by 30 publications

References 0 publications

The cost-effectiveness of the WINGS intervention: a program to prevent HIV and sexually transmitted diseases among high-risk urban women

The cost-effectiveness of the WINGS intervention: a program to prevent HIV and sexually transmitted diseases among high-risk urban women

Trends in, and determinants of, HIV testing at genitourinary medicine clinics and general practice in England, 1990-2000

The estimated prevalence and incidence of HIV in 96 large US metropolitan areas.

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