2017
The Clinical and Economic Impact of Attaining National HIV/AIDS Strategy Treatment Targets in the United States
Borre ED, Hyle EP, Paltiel AD, Neilan AM, Sax PE, Freedberg KA, Weinstein MC, Walensky RP. The Clinical and Economic Impact of Attaining National HIV/AIDS Strategy Treatment Targets in the United States. The Journal Of Infectious Diseases 2017, 216: 798-807. PMID: 29029344, PMCID: PMC5853503, DOI: 10.1093/infdis/jix349.Peer-Reviewed Original ResearchConceptsNational HIV/AIDS StrategyIncremental cost-effectiveness ratioHuman immunodeficiency virusCost-effectiveness ratioUS National HIV/AIDS StrategyHIV/AIDS StrategyAntiretroviral therapy costsSubstantial clinical benefitHigh HIV prevalenceGeneral US populationYears of lifeVirologic suppressionViral suppressionClinical outcomesAdherence interventionsClinical benefitHIV prevalenceHIV transmissionImmunodeficiency virusMSM populationAIDS StrategyTherapy costsTreatment targetsUS populationBlack menAn Adaptive Approach to Locating Mobile HIV Testing Services
Gonsalves GS, Crawford FW, Cleary PD, Kaplan EH, Paltiel AD. An Adaptive Approach to Locating Mobile HIV Testing Services. Medical Decision Making 2017, 38: 262-272. PMID: 28699382, PMCID: PMC5748375, DOI: 10.1177/0272989x17716431.Peer-Reviewed Original ResearchConceptsMobile HIV testingHIV testingMobile HIV testing servicesHIV testing resourcesUndetected HIV infectionHIV testing servicesCase detection ratePublic health agenciesUndiagnosed HIVHIV infectionHIV testHIV prevalenceUnknown prevalenceMore casesHealth agenciesDefinitions of hotspotsPrevalence informationTesting servicesPrevalenceSelection biasDetection rateSearch strategyHIV
2014
Mobile HIV Screening in Cape Town, South Africa: Clinical Impact, Cost and Cost-Effectiveness
Bassett IV, Govindasamy D, Erlwanger AS, Hyle EP, Kranzer K, van Schaik N, Noubary F, Paltiel AD, Wood R, Walensky RP, Losina E, Bekker LG, Freedberg KA. Mobile HIV Screening in Cape Town, South Africa: Clinical Impact, Cost and Cost-Effectiveness. PLOS ONE 2014, 9: e85197. PMID: 24465503, PMCID: PMC3898963, DOI: 10.1371/journal.pone.0085197.Peer-Reviewed Original ResearchConceptsIncremental cost-effectiveness ratioFacility-based testingHIV screeningHIV diagnosisFacility-based HIV testingFrequency of HIVUndiagnosed HIV prevalenceEarly HIV diagnosisLife expectancyMobile screening unitCost-effectiveness ratioResource-limited settingsCD4 countUndiagnosed HIVHIV testingHIV prevalenceCape TownClinical impactPopulation life expectancyMedical costsHIVScreening unitIntervention costsDiagnosisMedical facilities
2013
Routine HIV Screening in Portugal: Clinical Impact and Cost-Effectiveness
Yazdanpanah Y, Perelman J, DiLorenzo MA, Alves J, Barros H, Mateus C, Pereira J, Mansinho K, Robine M, Park JE, Ross EL, Losina E, Walensky RP, Noubary F, Freedberg KA, Paltiel AD. Routine HIV Screening in Portugal: Clinical Impact and Cost-Effectiveness. PLOS ONE 2013, 8: e84173. PMID: 24367639, PMCID: PMC3867470, DOI: 10.1371/journal.pone.0084173.Peer-Reviewed Original ResearchConceptsQuality-adjusted life yearsIncremental cost-effectiveness ratioQuality-adjusted life monthsRoutine HIVHIV test acceptanceRoutine HIV screeningAge 43 yearsCells/μLSecondary HIV transmissionHigh-risk groupHigh-risk populationRoutine screening programQuality-adjusted survivalCost-effectiveness ratioCD4 countHIV screeningClinical outcomesHIV prevalenceHIV transmissionFrequent screeningClinical impactNational HIVScreening programHigh incidenceHIV
2012
The cost-effectiveness of rapid HIV testing in substance abuse treatment: Results of a randomized trial
Schackman BR, Metsch LR, Colfax GN, Leff JA, Wong A, Scott CA, Feaster DJ, Gooden L, Matheson T, Haynes LF, Paltiel AD, Walensky RP. The cost-effectiveness of rapid HIV testing in substance abuse treatment: Results of a randomized trial. Drug And Alcohol Dependence 2012, 128: 90-97. PMID: 22971593, PMCID: PMC3546145, DOI: 10.1016/j.drugalcdep.2012.08.009.Peer-Reviewed Original ResearchConceptsQuality-adjusted life yearsSubstance abuse treatment programsNational HIV/AIDS StrategyCost-effectiveness ratioCommunity-based substance abuse treatment programsUndiagnosed HIV prevalenceRisk reduction counselingRapid HIV testingTreatment programHIV testingHIV prevalenceSite rapid testingSite rapid HIV testingHIV risk reduction counselingHIV/AIDS StrategyIncremental cost-effectiveness ratioHIV testing strategiesLife expectancyHIV testing offerPrior testing historyReceipt of resultsSubstance abuse treatmentRapid testingHIV screeningPatient demographics
2011
Resource Utilization and Cost-Effectiveness of Counselor- vs. Provider-Based Rapid Point-of-Care HIV Screening in the Emergency Department
Walensky RP, Morris BL, Reichmann WM, Paltiel AD, Arbelaez C, Donnell-Fink L, Katz JN, Losina E. Resource Utilization and Cost-Effectiveness of Counselor- vs. Provider-Based Rapid Point-of-Care HIV Screening in the Emergency Department. PLOS ONE 2011, 6: e25575. PMID: 22022415, PMCID: PMC3192047, DOI: 10.1371/journal.pone.0025575.Peer-Reviewed Original ResearchConceptsQuality-adjusted life yearsIncremental cost-effectiveness ratioUndiagnosed HIV prevalenceEmergency department settingCost-effectiveness ratioHIV prevalenceDepartment settingScreening modalityRandomized clinical trialsResource utilization dataRoutine HIVHIV screeningHIV counselorsEmergency departmentScreening servicesClinical trialsCapacity of providersScreening programED staffHIVTest offerLife yearsUtilization dataRapid pointPrevalenceThe potential impact of an HIV vaccine with rapidly waning protection on the epidemic in Southern Africa: Examining the RV144 trial results
Andersson KM, Paltiel AD, Owens DK. The potential impact of an HIV vaccine with rapidly waning protection on the epidemic in Southern Africa: Examining the RV144 trial results. Vaccine 2011, 29: 6107-6112. PMID: 21736912, PMCID: PMC3164284, DOI: 10.1016/j.vaccine.2011.06.076.Peer-Reviewed Original ResearchConceptsBooster vaccinationHIV prevalencePopulation coverage levelsRV144 trialHIV vaccineCondom useContinuous vaccinationHIV vaccine regimenPopulation HIV prevalenceDuration of protectionCoverage levelsRV144 vaccineVaccine regimenHIV infectionHeterosexual transmissionModest efficacyVaccine efficacyUnvaccinated populationVaccination strategiesPartial efficacyEfficacy vaccineLower riskVaccinationBooster strategyVaccineProjected Survival Gains from Revising State Laws Requiring Written Opt-in Consent for HIV Testing
April MD, Chiosi JJ, Paltiel AD, Sax PE, Walensky RP. Projected Survival Gains from Revising State Laws Requiring Written Opt-in Consent for HIV Testing. Journal Of General Internal Medicine 2011, 26: 661-667. PMID: 21286837, PMCID: PMC3101973, DOI: 10.1007/s11606-011-1637-5.Peer-Reviewed Original ResearchConceptsPotential survival gainsSurvival gainHIV testingDiagnosis rateAnnual HIV incidenceProportion of HIVUndiagnosed HIV prevalenceAnnual HIV diagnosis ratesHIV diagnosis ratesHIV incidenceHIV prevalenceEarly diagnosisHIVDisease controlLYGSurveillance dataAdult personsConsentConsent methodsPersonsPatientsConsent lawsBackgroundAlthoughDesignWeObjectiveToThe Clinical Impact and Cost-Effectiveness of Routine, Voluntary HIV Screening in South Africa
Walensky RP, Wood R, Fofana MO, Martinson NA, Losina E, April MD, Bassett IV, Morris BL, Freedberg KA, Paltiel AD. The Clinical Impact and Cost-Effectiveness of Routine, Voluntary HIV Screening in South Africa. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2011, 56: 26-35. PMID: 21068674, PMCID: PMC3005842, DOI: 10.1097/qai.0b013e3181fb8f24.Peer-Reviewed Original ResearchConceptsVoluntary HIV screeningQuality-adjusted life yearsHIV screeningLife yearsHIV case detectionHIV testing costsTest acceptance rateIncremental cost-effectiveness ratioSubstantial clinical benefitIncidence/prevalenceOne-time screeningDirect medical costsLife expectancyQuality-adjusted life expectancyCost-effectiveness ratioAntiretroviral therapyAnnual incidenceClinical benefitHIV prevalenceClinical impactCase detectionMedical costsCare ratesHIVTest acceptance
2010
Expanded HIV Screening in the United States: What Will It Cost Government Discretionary and Entitlement Programs? A Budget Impact Analysis
Martin EG, Paltiel AD, Walensky RP, Schackman BR. Expanded HIV Screening in the United States: What Will It Cost Government Discretionary and Entitlement Programs? A Budget Impact Analysis. Value In Health 2010, 13: 893-902. PMID: 20950323, PMCID: PMC2999642, DOI: 10.1111/j.1524-4733.2010.00763.x.Peer-Reviewed Original ResearchConceptsHIV screeningEarly treatment goalsNew HIV casesFrequency of screeningBudget impact analysisTotal budget increasesHIV careAnnual incidenceHIV casesHIV prevalenceCDC estimatesUS CentersTreatment goalsBudget impactTreatment programDisease controlHIVTest characteristicsTreatment costsFinancial burdenCareScreeningSmall proportionProgram savingsFund careRoutine HIV Screening in France: Clinical Impact and Cost-Effectiveness
Yazdanpanah Y, Sloan CE, Charlois-Ou C, Le Vu S, Semaille C, Costagliola D, Pillonel J, Poullié AI, Scemama O, Deuffic-Burban S, Losina E, Walensky RP, Freedberg KA, Paltiel AD. Routine HIV Screening in France: Clinical Impact and Cost-Effectiveness. PLOS ONE 2010, 5: e13132. PMID: 20976112, PMCID: PMC2956760, DOI: 10.1371/journal.pone.0013132.Peer-Reviewed Original ResearchConceptsQuality-adjusted life monthsCost-effectiveness ratioQuality-adjusted life yearsGeneral populationRoutine HIVHIV prevalenceFrequent screeningLife expectancyAnnual HIV incidenceRoutine HIV screeningUndiagnosed HIV prevalenceHigh-risk groupHIV testing behaviorsInjection drug usersFrench general populationEpidemiology of infectionHIV screeningVoluntary HIVHIV infectionHIV testingAnnual screeningHIV incidenceMean ageHIV screenClinical impactTest and Treat DC: Forecasting the Impact of a Comprehensive HIV Strategy in Washington DC
Walensky RP, Paltiel AD, Losina E, Morris BL, Scott CA, Rhode ER, Seage GR, Freedberg KA, Investigators F. Test and Treat DC: Forecasting the Impact of a Comprehensive HIV Strategy in Washington DC. Clinical Infectious Diseases 2010, 51: 392-400. PMID: 20617921, PMCID: PMC2906630, DOI: 10.1086/655130.Peer-Reviewed Original ResearchConceptsHIV RNA levelsAntiretroviral therapyLife expectancyAdministration of ARTHuman immunodeficiency virus (HIV) epidemicART initiation strategiesHIV case detectionRNA levelsUndiagnosed HIV prevalenceCells/microLEarly case identificationInitial mean ageRegular screening programsHIV screeningHIV testAnnual incidenceAnnual screeningHIV prevalenceHIV transmissionHIV strategiesMean ageHIV epidemicCase detectionScreening programART efficacy
2007
Predicting the Impact of a Partially Effective HIV Vaccine and Subsequent Risk Behavior Change on the Heterosexual HIV Epidemic in Low- and Middle-Income Countries
Andersson KM, Owens DK, Vardas E, Gray GE, McIntyre JA, Paltiel AD. Predicting the Impact of a Partially Effective HIV Vaccine and Subsequent Risk Behavior Change on the Heterosexual HIV Epidemic in Low- and Middle-Income Countries. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2007, 46: 78-90. PMID: 17589368, PMCID: PMC3570247, DOI: 10.1097/qai.0b013e31812506fd.Peer-Reviewed Original ResearchConceptsEffective HIV vaccineHIV prevalenceHIV vaccineCondom useHIV infectionRisk behaviorsFuture HIV prevalenceTotal HIV infectionsHeterosexual HIV epidemicSuccessful vaccination campaignsRisk behavior changeVaccination statusMiddle-income countriesVaccinated individualsVaccination coverageDisease stageVaccine efficacyHIV epidemicVaccination scenariosVaccination campaignHigh riskAdult populationVaccinePrevalenceInfection
2006
Expanded HIV screening in the United States: effect on clinical outcomes, HIV transmission, and costs.
Paltiel AD, Walensky RP, Schackman BR, Seage GR, Mercincavage LM, Weinstein MC, Freedberg KA. Expanded HIV screening in the United States: effect on clinical outcomes, HIV transmission, and costs. Annals Of Internal Medicine 2006, 145: 797-806. PMID: 17146064, DOI: 10.7326/0003-4819-145-11-200612050-00004.Peer-Reviewed Original ResearchConceptsCost-effectiveness ratioDollars/QALYHIV prevalenceAnnual incidenceHIV infectionRoutine HIVAntiretroviral therapyIncremental cost-effectiveness ratioModerate HIV prevalenceUndetected HIV infectionVoluntary HIV screeningUndiagnosed HIV infectionRapid HIV testingHIV patient careHIV transmission riskOne-time screeningQuality-adjusted survivalLifetime medical costsServices Utilization SurveySecondary transmissionBase-case analysisCost-effectiveness analysisHIV screeningObservational cohortHIV testing
2005
Optimal Allocation of Testing Dollars: The Example of HIV Counseling, Testing, and Referral
Walensky RP, Weinstein MC, Smith HE, Freedberg KA, Paltiel AD. Optimal Allocation of Testing Dollars: The Example of HIV Counseling, Testing, and Referral. Medical Decision Making 2005, 25: 321-329. PMID: 15951459, DOI: 10.1177/0272989x05276955.Peer-Reviewed Original ResearchMeSH KeywordsAIDS SerodiagnosisComputer SimulationContinuity of Patient CareCost-Benefit AnalysisCounselingDecision Support TechniquesHIV InfectionsHumansInvestmentsMass ScreeningModels, StatisticalPatient Acceptance of Health CarePrevalenceProbabilityQuality-Adjusted Life YearsReferral and ConsultationResource AllocationSensitivity and SpecificityUnited StatesConceptsCost-effectiveness ratioScreening programUndiagnosed HIV prevalenceHealth screening programHIV testing servicesHIV testingHIV counselingHIV prevalenceLimited screening resourcesClinical impactAppropriate careQALYTesting pathwayTesting servicesScreening resourcesPathway outcomesOptimal targetingCarePathwayEarly stagesHIVReferralAdditional peopleFollowLater stagesRoutine human immunodeficiency virus testing: An economic evaluation of current guidelines
Walensky RP, Weinstein MC, Kimmel AD, Seage GR, Losina E, Sax PE, Zhang H, Smith HE, Freedberg KA, Paltiel AD. Routine human immunodeficiency virus testing: An economic evaluation of current guidelines. The American Journal Of Medicine 2005, 118: 292-300. PMID: 15745728, DOI: 10.1016/j.amjmed.2004.07.055.Peer-Reviewed Original ResearchConceptsCost-effectiveness ratioHIV prevalenceCurrent guidelinesHuman immunodeficiency virus (HIV) counselingMean quality-adjusted life expectancyHIV Screening ProgramQuality-adjusted life expectancyLife-sustaining careOverall participation rateCost-effectiveness analysisUndiagnosed infectionHIV screeningHIV counselingClinical effectsReferral guidelinesPrevention guidelinesInfected patientsScreening programDisease controlPrevalenceU.S. hospitalsScreening thresholdLife expectancyHIVPatients