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Partner Notification for Reduction of HIV-1 Transmission and Related Costs among Men Who Have Sex with Men: A Mathematical Modeling Study

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Listed:
  • 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

Abstract

Background: Earlier antiretroviral treatment initiation prevents new HIV infections. A key problem in HIV prevention and care is the high number of patients diagnosed late, as these undiagnosed patients can continue forward HIV transmission. We modeled the impact on the Dutch men-who-have-sex-with-men (MSM) HIV epidemic and cost-effectiveness of an existing partner notification process for earlier identification of HIV-infected individuals to reduce HIV transmission. Methods: Reduction in new infections and cost-effectiveness ratios were obtained for the use of partner notification to identify 5% of all new diagnoses (Scenario 1) and 20% of all new diagnoses (Scenario 2), versus no partner notification. Costs and quality adjusted life years (QALYs) were assigned to each disease state and calculated over 5 year increments for a 20 year period. Results: Partner notification is predicted to avert 18–69 infections (interquartile range [IQR] 13–24; 51–93) over the course of 5 years countrywide to 221–830 (IQR 140–299; 530–1,127) over 20 years for Scenario 1 and 2 respectively. Partner notification was considered cost-effective in the short term, with increasing cost-effectiveness over time: from €41,476 -€41, 736 (IQR €40,529-€42,147; €40,791-€42,397) to €5,773 -€5,887 (€5,134-€7,196; €5,411-€6,552) per QALY gained over a 5 and 20 year period, respectively. The full monetary benefits of partner notification by preventing new HIV infections become more apparent over time. Conclusions: Partner notification will not lead to the end of the HIV epidemic, but will prevent new infections and be increasingly cost-effectiveness over time.

Suggested Citation

  • 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.
    • Handle: RePEc:plo:pone00:0142576
    DOI: 10.1371/journal.pone.0142576
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    References listed on IDEAS

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    1. 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.
    2. World Bank, 2014. "World Development Indicators 2014," World Bank Publications - Books, The World Bank Group, number 18237, December.
    3. Tonderai Mabuto & Mary H Latka & Bulelani Kuwane & Gavin J Churchyard & Salome Charalambous & Christopher J Hoffmann, 2014. "Four Models of HIV Counseling and Testing: Utilization and Test Results in South Africa," PLOS ONE, Public Library of Science, vol. 9(7), pages 1-7, July.
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