Cost-effectiveness of Injectable Preexposure Prophylaxis for HIV Prevention in South Africa
- Resource Type
- Authors
- Eran Bendavid; Greg Hood; John W. Mellors; Urvi M. Parikh; Robert Glaubius; Kerri J. Penrose; Ume L. Abbas
- Source
- Subject
- 0301 basic medicine
Microbiology (medical)
Prioritization
Adult
Male
medicine.medical_specialty
Adolescent
Cost effectiveness
Anti-HIV Agents
Cost-Benefit Analysis
030106 microbiology
Hiv epidemic
Population
Human immunodeficiency virus (HIV)
HIV Infections
medicine.disease_cause
Injections
03 medical and health sciences
Pre-exposure prophylaxis
chemistry.chemical_compound
South Africa
Young Adult
0302 clinical medicine
Environmental health
parasitic diseases
Medicine
Humans
030212 general & internal medicine
education
Epidemics
health care economics and organizations
education.field_of_study
business.industry
Rilpivirine
Reproducibility of Results
Middle Aged
Models, Theoretical
Antiretroviral therapy
Surgery
Infectious Diseases
chemistry
HIV/AIDS
Female
Pre-Exposure Prophylaxis
business
- Language
- English
BACKGROUND: Long-acting injectable antiretrovirals such as rilpivirine (RPV) could promote adherence to preexposure prophylaxis (PrEP) for human immunodeficiency virus (HIV) prevention. However the cost-effectiveness of injectable PrEP is unclear. METHODS: We constructed a dynamic model of the heterosexual HIV epidemic in KwaZulu-Natal South Africa and analyzed scenarios of RPV PrEP scale-up for combination HIV prevention in comparison with a reference scenario without PrEP. We estimated new HIV infections life-years and costs and incremental cost-effectiveness ratios (ICERs) over 10-year and lifetime horizons assuming a societal perspective. RESULTS: Compared with no PrEP unprioritized scale-up of RVP PrEP covering 2.5%-15% of adults prevented up to 9% of new infections over 10 years. HIV prevention doubled (17%) when the same coverage was prioritized to 20- to 29-year-old women costing $10 880-$19 213 per infection prevented. Prioritization of PrEP to 80% of individuals at highest behavioral risk achieved comparable prevention (4%-8%) at