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Cost-Effectiveness of Pre-Exposure Prophylaxis (PrEP) in Preventing HIV-1 Infections in Rural Zambia: A Modeling Study

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  • Brooke E Nichols
  • Charles A B Boucher
  • Janneke H van Dijk
  • Phil E Thuma
  • Jan L Nouwen
  • Rob Baltussen
  • Janneke van de Wijgert
  • Peter M A Sloot
  • David A M C van de Vijver

Abstract

Background: Pre-exposure prophylaxis (PrEP) with tenofovir and emtricitabine effectively prevents new HIV infections. The optimal scenario for implementing PrEP where most infections are averted at the lowest cost is unknown. We determined the impact of different PrEP strategies on averting new infections, prevalence, drug resistance and cost-effectiveness in Macha, a rural setting in Zambia. Methods: A deterministic mathematical model of HIV transmission was constructed using data from the Macha epidemic (antenatal prevalence 7.7%). Antiretroviral therapy is started at CD4

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  • Brooke E Nichols & Charles A B Boucher & Janneke H van Dijk & Phil E Thuma & Jan L Nouwen & Rob Baltussen & Janneke van de Wijgert & Peter M A Sloot & David A M C van de Vijver, 2013. "Cost-Effectiveness of Pre-Exposure Prophylaxis (PrEP) in Preventing HIV-1 Infections in Rural Zambia: A Modeling Study," PLOS ONE, Public Library of Science, vol. 8(3), pages 1-10, March.
    • Handle: RePEc:plo:pone00:0059549
    DOI: 10.1371/journal.pone.0059549
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    References listed on IDEAS

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    1. Drummond, Michael F. & Sculpher, Mark J. & Torrance, George W. & O'Brien, Bernie J. & Stoddart, Greg L., 2005. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 3, number 9780198529453.
    2. Carel Pretorius & John Stover & Lori Bollinger & Nicolas Bacaër & Brian Williams, 2010. "Evaluating the Cost-Effectiveness of Pre-Exposure Prophylaxis (PrEP) and Its Impact on HIV-1 Transmission in South Africa," PLOS ONE, Public Library of Science, vol. 5(11), pages 1-10, November.
    3. Benjamin Johns & Rob Baltussen, 2004. "Accounting for the cost of scaling‐up health interventions," Health Economics, John Wiley & Sons, Ltd., vol. 13(11), pages 1117-1124, November.
    4. World Bank, 2011. "World Development Indicators 2011," World Bank Publications - Books, The World Bank Group, number 2315, December.
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    Cited by:

    1. Brooke E Nichols & Hannelore M Götz & Eric C M van Gorp & Annelies Verbon & Casper Rokx & Charles A B Boucher & David A M C van de Vijver, 2015. "Partner Notification for Reduction of HIV-1 Transmission and Related Costs among Men Who Have Sex with Men: A Mathematical Modeling Study," PLOS ONE, Public Library of Science, vol. 10(11), pages 1-15, November.
    2. Sabina S Alistar & Douglas K Owens & Margaret L Brandeau, 2014. "Effectiveness and Cost Effectiveness of Oral Pre-Exposure Prophylaxis in a Portfolio of Prevention Programs for Injection Drug Users in Mixed HIV Epidemics," PLOS ONE, Public Library of Science, vol. 9(1), pages 1-11, January.

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