{"id":1238,"date":"2020-10-22T21:44:23","date_gmt":"2020-10-23T00:44:23","guid":{"rendered":"http:\/\/fundopositivo.org.br\/saudepositiva\/?p=1238"},"modified":"2020-10-22T21:44:23","modified_gmt":"2020-10-23T00:44:23","slug":"acabando-com-a-epidemia-de-hiv-entre-pessoas-que-injetam-drogas-uma-analise-de-custo-eficacia-em-seis-cidades-dos-eua","status":"publish","type":"post","link":"https:\/\/fundopositivo.org.br\/saudepositiva\/artigos\/acabando-com-a-epidemia-de-hiv-entre-pessoas-que-injetam-drogas-uma-analise-de-custo-eficacia-em-seis-cidades-dos-eua\/1238\/","title":{"rendered":"Acabando com a epidemia de HIV entre pessoas que injetam drogas: uma an\u00e1lise de custo-efic\u00e1cia em seis cidades dos EUA"},"content":{"rendered":"\n

Ending the HIV Epidemic Among Persons Who Inject Drugs: A Cost-Effectiveness Analysis in Six US Cities<\/em><\/p>\n\n\n\n

Emanuel Krebs,\u00a0Xiao Zang,\u00a0Benjamin Enns,\u00a0Jeong E Min,\u00a0Czarina N Behrends,\u00a0Carlos Del Rio,\u00a0Julia C Dombrowski,\u00a0Daniel J Feaster,\u00a0Kelly A Gebo,\u00a0Brandon D L Marshall,\u00a0Shruti H Mehta,\u00a0Lisa R Metsch,\u00a0Ankur Pandya,\u00a0Bruce R Schackman,\u00a0Steffanie A Strathdee,\u00a0Bohdan Nosyk<\/em><\/p>\n\n\n\n

Background<\/p>\n\n\n\n

Persons who inject drugs (PWID) are at a disproportionately high risk of HIV infection. We aimed to determine the highest-valued combination implementation strategies to reduce the burden of HIV among PWID in 6 US cities.Methods<\/p>\n\n\n\n

Using a dynamic HIV transmission model calibrated for Atlanta, Baltimore, Los Angeles, Miami, New York City, and Seattle, we assessed the value of implementing combinations of evidence-based interventions at optimistic (drawn from best available evidence) or ideal (90% coverage) scale-up. We estimated reduction in HIV incidence among PWID, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios (ICERs) for each city (10-year implementation; 20-year horizon; 2018 $ US).Results<\/p>\n\n\n\n

Combinations that maximized health benefits contained between 6 (Atlanta and Seattle) and 12 (Miami) interventions with ICER values ranging from $94 069\/QALY in Los Angeles to $146\u2005256\/QALY in Miami. These strategies reduced HIV incidence by 8.1% (credible interval [CI], 2.8%\u201313.2%) in Seattle and 54.4% (CI, 37.6%\u201373.9%) in Miami. Incidence reduction reached 16.1%\u201375.5% at ideal scale.Conclusions<\/p>\n\n\n\n

Evidence-based interventions targeted to PWID can deliver considerable value; however, ending the HIV epidemic among PWID will require innovative implementation strategies and supporting programs to reduce social and structural barriers to care.<\/p>\n\n\n\n

Acesse: https:\/\/academic.oup.com\/jid\/article-abstract\/222\/Supplement_5\/S301\/5900595<\/p>\n","protected":false},"excerpt":{"rendered":"

Ending the HIV Epidemic Among Persons Who Inject Drugs: A Cost-Effectiveness Analysis in Six US Cities Emanuel Krebs,\u00a0Xiao Zang,\u00a0Benjamin Enns,\u00a0Jeong E Min,\u00a0Czarina N Behrends,\u00a0Carlos Del Rio,\u00a0Julia C Dombrowski,\u00a0Daniel J Feaster,\u00a0Kelly A Gebo,\u00a0Brandon D L Marshall,\u00a0Shruti H Mehta,\u00a0Lisa R Metsch,\u00a0Ankur Pandya,\u00a0Bruce R Schackman,\u00a0Steffanie A Strathdee,\u00a0Bohdan Nosyk Background Persons who inject drugs (PWID) are at a disproportionately high risk of HIV infection. We aimed to determine the highest-valued combination implementation strategies to reduce the burden of HIV among PWID in 6 US cities.Methods Using a dynamic HIV transmission model calibrated for Atlanta, Baltimore, Los Angeles, Miami, New York City, and Seattle, we assessed the value of implementing combinations of evidence-based interventions at optimistic (drawn from best available evidence) or ideal (90% coverage) scale-up. We estimated reduction in HIV incidence among PWID, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios (ICERs) for each city (10-year implementation; 20-year horizon; 2018 $ US).Results Combinations that maximized health benefits contained between 6 (Atlanta and Seattle) and 12 (Miami) interventions with ICER values ranging from $94 069\/QALY in Los Angeles to $146\u2005256\/QALY in Miami. These strategies reduced HIV incidence by 8.1% (credible interval [CI], 2.8%\u201313.2%) in Seattle and 54.4% (CI, 37.6%\u201373.9%) in Miami. Incidence reduction reached 16.1%\u201375.5% at ideal scale.Conclusions Evidence-based interventions targeted to PWID can deliver considerable value; however, ending the HIV epidemic among PWID will require innovative implementation strategies and supporting programs to reduce social and structural barriers to care. Acesse: https:\/\/academic.oup.com\/jid\/article-abstract\/222\/Supplement_5\/S301\/5900595<\/p>\n","protected":false},"author":3,"featured_media":1240,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"spay_email":""},"categories":[28],"tags":[131,133,38,132,129,130],"jetpack_featured_media_url":"https:\/\/fundopositivo.org.br\/saudepositiva\/wp-content\/uploads\/2020\/10\/drogas.jpg","_links":{"self":[{"href":"https:\/\/fundopositivo.org.br\/saudepositiva\/wp-json\/wp\/v2\/posts\/1238"}],"collection":[{"href":"https:\/\/fundopositivo.org.br\/saudepositiva\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/fundopositivo.org.br\/saudepositiva\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/fundopositivo.org.br\/saudepositiva\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/fundopositivo.org.br\/saudepositiva\/wp-json\/wp\/v2\/comments?post=1238"}],"version-history":[{"count":1,"href":"https:\/\/fundopositivo.org.br\/saudepositiva\/wp-json\/wp\/v2\/posts\/1238\/revisions"}],"predecessor-version":[{"id":1239,"href":"https:\/\/fundopositivo.org.br\/saudepositiva\/wp-json\/wp\/v2\/posts\/1238\/revisions\/1239"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/fundopositivo.org.br\/saudepositiva\/wp-json\/wp\/v2\/media\/1240"}],"wp:attachment":[{"href":"https:\/\/fundopositivo.org.br\/saudepositiva\/wp-json\/wp\/v2\/media?parent=1238"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/fundopositivo.org.br\/saudepositiva\/wp-json\/wp\/v2\/categories?post=1238"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/fundopositivo.org.br\/saudepositiva\/wp-json\/wp\/v2\/tags?post=1238"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}