HIV Tests And New Diagnoses Declined After California Budget Cuts, But Reallocating Funds Helped Reduce Impact

Leibowitz, Arleen; Byrnes, Karen; Wynn, Adriane; Farrell, Kevin

doi:10.1377/hlthaff.2013.0965

Cited by 4 publications

(3 citation statements)

References 10 publications

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“…However, these too are sensitive to budget cuts (79, 80). In the past, when local HIV budgets have contracted (e.g.…”

Section: Discussionmentioning

confidence: 99%

“…In the past, when local HIV budgets have contracted (e.g. California’s budget shortfall in 2009) (79), detailed surveillance data was instrumental in targeting resources to high risk communities and stemming additional infections in the short term (79, 81). Although state funds may be able to compensate for short term losses in federal support, the sustainability of programs may be challenged.…”

Section: Discussionmentioning

confidence: 99%

“…With changes to the ACA still a possibility, and the role for Ryan White funds in achieving access and retention in care unclear, discretionary funds at the state-level may alleviate some discrepancies in funding. However, these too are sensitive to budget cuts (79, 80). In the past, when local HIV budgets have contracted (e.g.…”

Section: Discussionmentioning

confidence: 99%

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Building the Case for Localized Approaches to HIV: Structural Conditions and Health System Capacity to Address the HIV/AIDS Epidemic in Six US Cities

et al. 2018

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Since the discovery of the secondary preventive benefits of antiretroviral therapy, national and international governing bodies have called for countries to reach 90% diagnosis, ART engagement and viral suppression among people living with HIV/AIDS. The US HIV epidemic is dispersed primarily across large urban centers, each with different underlying epidemiological and structural features. We selected six US cities, including Atlanta, Baltimore, Los Angeles, Miami, New York, and Seattle, with the objective of demonstrating the breadth of epidemiological and structural differences affecting the HIV/AIDS response across the US. We synthesized current and publicly-available surveillance, legal statutes, entitlement and discretionary funding, and service location data for each city. The vast differences we observed in each domain reinforce disparities in access to HIV treatment and prevention, and necessitate targeted, localized strategies to optimize the limited resources available for each city's HIV/AIDS response.

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“…However, these too are sensitive to budget cuts (79, 80). In the past, when local HIV budgets have contracted (e.g.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Building the Case for Localized Approaches to HIV: Structural Conditions and Health System Capacity to Address the HIV/AIDS Epidemic in Six US Cities

et al. 2018

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Consequences of restricted STI testing for young heterosexuals in the Netherlands on test costs and QALY losses

et al. 2018

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VP35 Economic Consequences Of A Restricted Dutch Sexually Transmitted Infection-Testing Policy

Suijkerbuijk¹,

Over²,

Aar³

et al. 2017

Int J Technol Assess Health Care

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INTRODUCTION:Due to the rising costs caused by an increasing demand for Sexually Transmitted Infection (STI) care, the Dutch government changed the funding of STI-clinics (1). A more restrictive testing policy introduced in 2015 no longer required syphilis and human immunodeficiency virus (HIV) tests for younger, heterosexual clients. A less extensive testing policy could be detrimental to the aim of finding and treating STIs (2,3). Infections that remain undetected could possibly lead to an increase in both the total and individual burden of disease, due to transmission and the need for more intensive treatment resulting in higher healthcare costs in the long term. In this study, we evaluated the new Dutch testing policy with respect to intended savings and missed syphilis and/or HIV infections. Moreover, we explored the efficiency of alternative test policies.METHODS:Using national surveillance data from 2011 to 2013 with still comprehensive testing for all, we estimated the effects of restrictive testing on test costs, number of infections missed, costs per missed infection, costs per Quality Adjusted Life Year (QALY) lost, and calculated the net monetary benefit.RESULTS:The 2015-policy led to estimated savings of EUR1.1 million, while missing approximately three of ten HIV infections and seven of twenty syphilis infections among all younger heterosexual clients (in total 143,612 consultations) per year. Savings were EUR435,000 per QALY lost. Standard testing second-generation immigrants for syphilis and HIV saved EUR525,000/QALY lost. Offering an HIV test when diagnosed with chlamydia or gonorrhoea resulted in savings of EUR568,000/ QALY lost.CONCLUSIONS:The 2015-testing policy resulted in substantial savings as few missed HIV and syphilis infections caused QALY losses. Additional standard syphilis and HIV tests for second-generation immigrants and an additional HIV test in case of positive chlamydia or gonorrhoea diagnosis could reduce missed infections in a cost-effective way.

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HIV Tests And New Diagnoses Declined After California Budget Cuts, But Reallocating Funds Helped Reduce Impact

Cited by 4 publications

References 10 publications

Building the Case for Localized Approaches to HIV: Structural Conditions and Health System Capacity to Address the HIV/AIDS Epidemic in Six US Cities

Building the Case for Localized Approaches to HIV: Structural Conditions and Health System Capacity to Address the HIV/AIDS Epidemic in Six US Cities

Consequences of restricted STI testing for young heterosexuals in the Netherlands on test costs and QALY losses

VP35 Economic Consequences Of A Restricted Dutch Sexually Transmitted Infection-Testing Policy

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