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- Title
Why Maximizing Quality-Adjusted Life Years, rather than Reducing HIV Incidence, Must Remain Our Objective in Addressing the HIV/AIDS Epidemic.
- Authors
Nosyk, Bohdan; Min, Jeong Eun; Zang, Xiao; Feaster, Daniel J.; Metsch, Lisa; Marshall, Brandon D. L.; Rio, Carlos Del; Granich, Reuben; Schackman, Bruce R.; Montaner, Julio S. G.
- Abstract
With efficacious behavioral, biomedical, and structural interventions available, combination implementation strategies are being implemented to combat HIV/AIDS across settings internationally. However, priority statements from national and international bodies make it unclear whether the objective should be the reduction in HIV incidence or the maximization of health, most commonly measured with quality-adjusted life years (QALYs). Building off a model-based evaluation of HIV care interventions in British Columbia, Canada, we compare the optimal sets of interventions that would be identified using HIV infections averted, and QALYs as the primary outcome in a cost-effectiveness analysis. We found an explicit focus on averting new infections undervalues the health benefits derived from antiretroviral therapy, resulting in suboptimal and potentially harmful funding recommendations.
- Subjects
BRITISH Columbia; CANADA; QUALITY-adjusted life years; AIDS; HIV infections; HIV; AIDS prevention; HIV prevention; ANTI-HIV agents; RESEARCH; RESEARCH methodology; MEDICAL care costs; DISEASE incidence; EVALUATION research; MEDICAL cooperation; HIGHLY active antiretroviral therapy; COMPARATIVE studies; COST effectiveness; RESEARCH funding; STATISTICAL models
- Publication
Journal of the International Association of Providers of AIDS Care, 2019, Vol 18, pN.PAG
- ISSN
2325-9582
- Publication type
journal article
- DOI
10.1177/2325958218821962