Estimating Productivity Losses per HIV Infection due to Premature HIV Mortality in the United States

Background Updated estimates of the productivity losses per HIV infection due to premature HIV mortality are needed to help quantify the economic burden of HIV and inform cost-effectiveness analyses. Methods We used the human capital approach to estimate the productivity loss due to HIV mortality per HIV infection in the United States, discounted to the time of HIV infection. We incorporated published data on age-specific annual productivity, life expectancy at HIV diagnosis, life-years lost from premature death among persons with HIV (PWH), the number of years from HIV infection to diagnosis, and the percentage of deaths in PWH attributable to HIV. For the base case, we used 2018 life expectancy data for all PWH in the United States. We also examined scenarios using life expectancy in 2010 and life expectancy for cohorts on antiretroviral therapy (ART). We conducted sensitivity analyses to understand the impact of key input parameters. Results We estimated the base-case overall average productivity loss due to HIV mortality per HIV infection at $65,300 in 2022 US dollars. The base-case results showed a 45% decrease in the estimated productivity loss compared with the results when applying life expectancy data from 2010. Productivity loss was 83% lower for cohorts of PWH on ART compared with the base-case scenario. Results were sensitive to assumptions about percentage of deaths attributable to HIV and heterogeneity in age at death. Conclusion This study provides valuable insights into the economic impact of HIV mortality, illustrating reductions in productivity losses over time due to advancements in treatments. Highlights Updated estimates of productivity losses per HIV infection due to premature HIV mortality can help assess the total economic burden of HIV in the United States. This study estimates productivity losses per HIV infection for overall, by sex, and by varying ages of HIV infection. Advancement in treatment has contributed to a significant reduction in productivity losses due to premature HIV mortality in the United States over the past decade.