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Effectiveness and cost-effectiveness of strategies to expand antiretroviral therapy in St. Petersburg, Russia.

Publication ,  Journal Article
Long, EF; Brandeau, ML; Galvin, CM; Vinichenko, T; Tole, SP; Schwartz, A; Sanders, GD; Owens, DK
Published in: AIDS
November 14, 2006

OBJECTIVE: To assess the effectiveness and cost-effectiveness of treating HIV-infected injection drug users (IDUs) and non-IDUs in Russia with highly active antiretroviral therapy HAART. DESIGN AND METHODS: A dynamic HIV epidemic model was developed for a population of IDUs and non-IDUs. The location for the study was St. Petersburg, Russia. The adult population aged 15 to 49 years was subdivided on the basis of injection drug use and HIV status. HIV treatment targeted to IDUs and non-IDUs, and untargeted treatment interventions were considered. Health care costs and quality-adjusted life years (QALYs) experienced in the population were measured, and HIV prevalence, HIV infections averted, and incremental cost-effectiveness ratios of different HAART strategies were calculated. RESULTS: With no incremental HAART programs, HIV prevalence reached 64% among IDUs and 1.7% among non-IDUs after 20 years. If treatment were targeted to IDUs, over 40 000 infections would be prevented (75% among non-IDUs), adding 650 000 QALYs at a cost of USD 1501 per QALY gained. If treatment were targeted to non-IDUs, fewer than 10 000 infections would be prevented, adding 400 000 QALYs at a cost of USD 2572 per QALY gained. Untargeted strategies prevented the most infections, adding 950 000 QALYs at a cost of USD 1827 per QALY gained. Our results were sensitive to HIV transmission parameters. CONCLUSIONS: Expanded use of antiretroviral therapy in St. Petersburg, Russia would generate enormous population-wide health benefits and be economically efficient. Exclusively treating non-IDUs provided the least health benefit, and was the least economically efficient. Our findings highlight the urgency of initiating HAART for both IDUs and non-IDUs in Russia.

Duke Scholars

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Published In

AIDS

DOI

ISSN

0269-9370

Publication Date

November 14, 2006

Volume

20

Issue

17

Start / End Page

2207 / 2215

Location

England

Related Subject Headings

  • Virology
  • Substance Abuse, Intravenous
  • Russia
  • Quality-Adjusted Life Years
  • Prevalence
  • Middle Aged
  • Humans
  • HIV Infections
  • Cost-Benefit Analysis
  • Antiretroviral Therapy, Highly Active
 

Citation

APA
Chicago
ICMJE
MLA
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Long, E. F., Brandeau, M. L., Galvin, C. M., Vinichenko, T., Tole, S. P., Schwartz, A., … Owens, D. K. (2006). Effectiveness and cost-effectiveness of strategies to expand antiretroviral therapy in St. Petersburg, Russia. AIDS, 20(17), 2207–2215. https://doi.org/10.1097/QAD.0b013e328010c7d0
Long, Elisa F., Margaret L. Brandeau, Cristina M. Galvin, Tatyana Vinichenko, Swati P. Tole, Adam Schwartz, Gillian D. Sanders, and Douglas K. Owens. “Effectiveness and cost-effectiveness of strategies to expand antiretroviral therapy in St. Petersburg, Russia.AIDS 20, no. 17 (November 14, 2006): 2207–15. https://doi.org/10.1097/QAD.0b013e328010c7d0.
Long EF, Brandeau ML, Galvin CM, Vinichenko T, Tole SP, Schwartz A, et al. Effectiveness and cost-effectiveness of strategies to expand antiretroviral therapy in St. Petersburg, Russia. AIDS. 2006 Nov 14;20(17):2207–15.
Long, Elisa F., et al. “Effectiveness and cost-effectiveness of strategies to expand antiretroviral therapy in St. Petersburg, Russia.AIDS, vol. 20, no. 17, Nov. 2006, pp. 2207–15. Pubmed, doi:10.1097/QAD.0b013e328010c7d0.
Long EF, Brandeau ML, Galvin CM, Vinichenko T, Tole SP, Schwartz A, Sanders GD, Owens DK. Effectiveness and cost-effectiveness of strategies to expand antiretroviral therapy in St. Petersburg, Russia. AIDS. 2006 Nov 14;20(17):2207–2215.

Published In

AIDS

DOI

ISSN

0269-9370

Publication Date

November 14, 2006

Volume

20

Issue

17

Start / End Page

2207 / 2215

Location

England

Related Subject Headings

  • Virology
  • Substance Abuse, Intravenous
  • Russia
  • Quality-Adjusted Life Years
  • Prevalence
  • Middle Aged
  • Humans
  • HIV Infections
  • Cost-Benefit Analysis
  • Antiretroviral Therapy, Highly Active