scholarly journals Health Utility Estimates and Their Application to HIV Prevention in the United States: Implications for Cost-Effectiveness Modeling and Future Research Needs

2020 ◽  
Vol 5 (2) ◽  
pp. 238146832093621
Author(s):  
Hilary K. Whitham ◽  
Angela B. Hutchinson ◽  
Ram K. Shrestha ◽  
Miriam Kuppermann ◽  
Birgit Grund ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Hiv Prevention ◽  
Data Collection ◽  
Health Utility ◽  
The United States ◽  
Hiv Treatment ◽  
Future Research ◽  
Medical Monitoring ◽  
Reporting Practices ◽  
Medical Monitoring Project

Objectives. Health utility estimates from the current era of HIV treatment, critical for cost-effectiveness analyses (CEA) informing HIV health policy, are limited. We examined peer-reviewed literature to assess the appropriateness of commonly referenced utilities, present previously unreported quality-of-life data from two studies, and discuss future implications for HIV-related CEA. Methods. We searched a database of cost-effectiveness analyses specific to HIV prevention efforts from 1999 to 2016 to identify the most commonly referenced sources for health utilities and to examine practices around using and reporting health utility data. Additionally, we present new utility estimates from the Centers of Disease Control and Prevention’s Medical Monitoring Project (MMP) and the INSIGHT Strategies for Management of Anti-Retroviral Therapy (SMART) trial. We compare data collection time frames, sample characteristics, assessment methods, and key estimates. Results. Data collection for the most frequently cited utility estimates ranged from 1985 to 1997, predating modern HIV treatment. Reporting practices around utility weights are poor and lack details on participant characteristics, which may be important stratifying factors for CEA. More recent utility estimates derived from MMP and SMART were similar across CD4+ count strata and had a narrower range than pre–antiretroviral therapy (ART) utilities. Conclusions. Despite the widespread use of ART, cost-effectiveness analysis of HIV prevention interventions frequently apply pre-ART health utility weights. Use of utility weights reflecting the current state of the US epidemic are needed to best inform HIV research and public policy decisions. Improved practices around the selection, application, and reporting of health utility data used in HIV prevention CEA are needed to improve transparency.

scholarly journals A systematic review of mHealth interventions for HIV prevention and treatment among gay, bisexual, and other men who have sex with men

2020 ◽  
Vol 10 (5) ◽  
pp. 1211-1220
Author(s):  
Kimberly M Nelson ◽  
Nicholas S Perry ◽  
Keith J Horvath ◽  
Laramie R Smith
Keyword(s):  
Systematic Review ◽  
Hiv Prevention ◽  
Text Messaging ◽  
Controlled Trial ◽  
The United States ◽  
Current Evidence ◽  
Future Research ◽  
Targeted Prevention ◽  
Prevention And Treatment ◽  
Sex With Men

Abstract The use of mobile health (mHealth) technologies addressing HIV disparities among gay, bisexual, and other men who have sex with men (GBMSM) has increased. A systematic review of mHealth interventions for HIV prevention and treatment among GBMSM was conducted to summarize the current evidence and provide recommendations for future research. PRISMA guidelines were followed (PROSPERO ID: 148452). Studies identified via PubMed, PsychInfo, or Embase were included that (i) were in English, (ii) were published in a peer-reviewed journal prior to July 1, 2019, (iii) presented primary results, (iv) included only GBMSM, and (v) reported the results of an mHealth intervention (e.g., text message, phone/mobile application [app]) to improve HIV prevention or treatment outcomes. Of 1,636 identified abstracts, 16 published studies met inclusion criteria. Eleven studies were conducted in the United States. One study was a fully powered randomized controlled trial (RCT), seven were single-arm pilots with pre–post assessments, four were pilot RCTs, and four tested public health campaigns with post-assessments. Seven developed study-specific apps, five used text messaging, and four used existing social networking apps. Most (81%) targeted prevention outcomes. Nine cited a specific behavioral theory. All studies found that a mHealth approach was feasible and acceptable. All interventions provided evidence of preliminary efficacy or promising trends on primary outcomes. Although mHealth interventions for HIV prevention and treatment appear feasible and acceptable, most published studies are small pilot trials. Additional research assessing the efficacy and mechanisms of mHealth interventions is needed.

Exchange sex among people receiving medical care for HIV in the United States – medical monitoring project 2009–2013

AIDS Care ◽  
2018 ◽  
Vol 30 (10) ◽  
pp. 1315-1321 ◽  
Author(s):  
Oluwatosin Olaiya ◽  
Lina Nerlander ◽  
Christine L. Mattson ◽  
Linda Beer
Keyword(s):  
United States ◽  
Medical Care ◽  
The United States ◽  
Medical Monitoring ◽  
Exchange Sex ◽  
Medical Monitoring Project

scholarly journals HIV Care Outcomes among Hispanics/Latinos with Diagnosed HIV in the United States by Place of Birth-2015–2018, Medical Monitoring Project

2019 ◽  
Vol 17 (1) ◽  
pp. 171
Author(s):  
Hanna B. Demeke ◽  
Qingwei Luo ◽  
Ruth E. Luna-Gierke ◽  
Mabel Padilla ◽  
Gladys Girona-Lozada ◽  
...  
Keyword(s):  
Mental Health ◽  
United States ◽  
Viral Suppression ◽  
The United States ◽  
Hiv Care ◽  
Medical Monitoring ◽  
Place Of Birth ◽  
Sustained Viral Suppression ◽  
Medical Monitoring Project ◽  
Hiv Aids

Relocation from one’s birthplace may affect human immunodeficiency virus (HIV) outcomes, but national estimates of HIV outcomes among Hispanics/Latinos by place of birth are limited. We analyzed Medical Monitoring Project data collected in 2015–2018 from 2564 HIV-positive Hispanic/Latino adults and compared clinical outcomes between mainland US-born (referent group), Puerto Rican (PR-born), and those born outside the United States (non-US-born). We reported weighted percentages of characteristics and used logistic regression with predicted marginal means to examine differences between groups (p < 0.05). PR-born Hispanics/Latinos were more likely to be prescribed antiretroviral therapy (ART) (94%) and retained in care (94%) than mainland-US-born (79% and 77%, respectively) and non-US-born (91% and 87%, respectively) Hispanics/Latinos. PR-born Hispanics/Latinos were more likely to have sustained viral suppression (75%) than mainland-US-born Hispanics/Latinos (57%). Non-US-born Hispanics/Latinos were more likely to be prescribed ART (91% vs. 79%), retained in care (87% vs. 77%), and have sustained viral suppression (74% vs. 57%) than mainland-US-born Hispanics/Latinos. Greater Ryan White HIV/AIDS-funded facility usage among PR-born, better mental health among non-US-born, and less drug use among PR-born and non-US-born Hispanics/Latinos may have contributed to better HIV outcomes. Expanding programs with comprehensive HIV/AIDS services, including for mental health and substance use, may reduce HIV outcome disparities among Hispanics/Latinos.

Cost-Effectiveness Analysis in Implementation Science

2018 ◽  
Author(s):  
Heather Taffet Gold
Keyword(s):  
Cost Effectiveness ◽  
Implementation Science ◽  
The United States ◽  
Cost Effectiveness Analysis ◽  
Future Research ◽  
Alternative Health ◽  
Alternative Health Care ◽  
Health Care Interventions ◽  
Effectiveness Analysis ◽  
Trade Offs

Cost-effectiveness analysis is a tool used to systematically and quantitatively compare trade-offs between health outcomes and costs of alternative health care interventions with standards set for the United States. Many recommendations, however, may not coalesce with implementation science methods. There is a lack of consensus for economic evaluation in implementation science that has resulted in conflicting norms and conventions, which in turn make analyses difficult to compare, raise quality concerns, and may put the relevance of research into question. This chapter suggests new standards as areas for future research to improve the quality, rigor, transparency, and ultimately comparability of cost-effectiveness analyses in implementation science.

Journaling among home care workers during the COVID-19 pandemic: A promising method for qualitative data collection

2021 ◽  
pp. 147332502110648
Author(s):  
Julia I Bandini ◽  
Julia Rollison ◽  
Jason Etchegaray
Keyword(s):  
Public Health ◽  
Data Collection ◽  
Home Care ◽  
Lived Experiences ◽  
Health Agency ◽  
The United States ◽  
Lessons Learned ◽  
Future Research ◽  
Care Workers ◽  
Home Care Workers

Qualitative methods that capture individual lived experiences throughout rapidly changing circumstances are particularly important during public health emergencies. The COVID-19 pandemic has put home care workers at risk as they provide vital services in homes to individuals with chronic conditions or disabilities. Using a 6-week journaling process in which we enrolled participants at different points, we sought to examine experiences of home care workers ( n = 47) in the United States in New York and Michigan during April–July 2020 of the COVID-19 pandemic. Our methods for data collection and analysis were guided by a general qualitative approach as we aimed to examine the weekly perspectives and lived experiences of home care workers. We asked individuals to respond to our journaling prompts weekly to capture their reflections in “real time.” To better understand home care workers’ perspectives on journaling and the broader external context in which they provided care, we triangulated our data with interviews with home care workers ( n = 19) and home health agency representatives ( n = 9). We explored the feasibility of a rolling journaling process during an unprecedented public health emergency, characterized by rapid changes and uncertainty in day-to-day life, and reflect on lessons learned to guide future research on journaling for data collection, particularly for marginalized workers during public health crises, when events are evolving rapidly.

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