Modeling the future of HIV in Turkey: Cost-effectiveness analysis of improving testing and diagnosis
This study aimed to determine HIV incidence and prevalence in Turkey and to estimate the cost-effectiveness of improving testing and diagnosis in the next 20 years. HIV incidence in Turkey has been rapidly increasing in the last decade with a particularly high rate of infection for younger populatio...
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| Veröffentlicht in: | PloS one 2023-06, Vol.18 (6), p.e0286254-e0286254 |
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| creator | Yaylali, Emine Erdogan, Zikriye Melisa Calisir, Fethi Gokengin, Deniz Korten, Volkan Tabak, Fehmi Tasova, Yesim Unal, Serhat Ozelgun, Berna Ozcagli, Tahsin Gokcem Sahin, Toros |
| description | This study aimed to determine HIV incidence and prevalence in Turkey and to estimate the cost-effectiveness of improving testing and diagnosis in the next 20 years.
HIV incidence in Turkey has been rapidly increasing in the last decade with a particularly high rate of infection for younger populations, which underscores the urgent need for a robust prevention program and improved testing capacity for HIV.
We developed a dynamic compartmental model of HIV transmission and progression among the Turkish population aged 15-64 and assessed the effect of improving testing and diagnosis. The model generated the number of new HIV cases by transmission risk and CD4 level, HIV diagnoses, HIV prevalence, continuum of care, the number of HIV-related deaths, and the expected number of infections prevented from 2020 to 2040. We also explored the cost impact of HIV and the cost-effectiveness of improving testing and diagnosis.
Under the base case scenario, the model estimated an HIV incidence of 13,462 cases in 2020, with 63% undiagnosed. The number of infections was estimated to increase by 27% by 2040, with HIV incidence in 2040 reaching 376,889 and HIV prevalence 2,414,965 cases. Improving testing and diagnosis to 50%, 70%, and 90%, would prevent 782,789, 2,059,399, and 2,336,564 infections-32%, 85%, and 97% reduction in 20 years, respectively. Improved testing and diagnosis would reduce spending between $1.8 and $8.8 billion.
In the case of no improvement in the current continuum of care, HIV incidence and prevalence will significantly increase over the next 20 years, placing a significant burden on the Turkish healthcare system. However, improving testing and diagnosis could substantially reduce the number of infections, ameliorating the public health and disease burden aspects. |
| doi_str_mv | 10.1371/journal.pone.0286254 |
| format | Article |
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HIV incidence in Turkey has been rapidly increasing in the last decade with a particularly high rate of infection for younger populations, which underscores the urgent need for a robust prevention program and improved testing capacity for HIV.
We developed a dynamic compartmental model of HIV transmission and progression among the Turkish population aged 15-64 and assessed the effect of improving testing and diagnosis. The model generated the number of new HIV cases by transmission risk and CD4 level, HIV diagnoses, HIV prevalence, continuum of care, the number of HIV-related deaths, and the expected number of infections prevented from 2020 to 2040. We also explored the cost impact of HIV and the cost-effectiveness of improving testing and diagnosis.
Under the base case scenario, the model estimated an HIV incidence of 13,462 cases in 2020, with 63% undiagnosed. The number of infections was estimated to increase by 27% by 2040, with HIV incidence in 2040 reaching 376,889 and HIV prevalence 2,414,965 cases. Improving testing and diagnosis to 50%, 70%, and 90%, would prevent 782,789, 2,059,399, and 2,336,564 infections-32%, 85%, and 97% reduction in 20 years, respectively. Improved testing and diagnosis would reduce spending between $1.8 and $8.8 billion.
In the case of no improvement in the current continuum of care, HIV incidence and prevalence will significantly increase over the next 20 years, placing a significant burden on the Turkish healthcare system. However, improving testing and diagnosis could substantially reduce the number of infections, ameliorating the public health and disease burden aspects.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0286254</identifier><identifier>PMID: 37390076</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Acquired immune deficiency syndrome ; AIDS ; Analysis ; Antiretroviral drugs ; Biology and Life Sciences ; Care and treatment ; CD4 antigen ; Cost analysis ; Cost benefit analysis ; Cost of Illness ; Cost-Effectiveness Analysis ; Diagnosis ; Disease prevention ; Disease transmission ; Economic aspects ; Effectiveness ; Epidemics ; Epidemiological Models ; Epidemiology ; Evaluation ; Health aspects ; Health care reform ; Heterosexuality ; HIV ; HIV (Viruses) ; HIV Infections - diagnosis ; HIV Infections - epidemiology ; HIV testing ; HIV-2 ; Human immunodeficiency virus ; Humans ; Infection ; Infectious diseases ; Management ; Medical care, Cost of ; Medical diagnosis ; Medical research ; Medicine and health sciences ; Medicine, Experimental ; Modelling ; Mortality ; Patients ; People and Places ; Pharmacy ; Population ; Prevention ; Public health ; Turkey - epidemiology</subject><ispartof>PloS one, 2023-06, Vol.18 (6), p.e0286254-e0286254</ispartof><rights>Copyright: © 2023 Yaylali et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</rights><rights>COPYRIGHT 2023 Public Library of Science</rights><rights>2023 Yaylali et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2023 Yaylali et al 2023 Yaylali et al</rights><rights>2023 Yaylali et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c623t-5499d3ab4784401ad2ca4c10976c11853c09c0a12b414047e757ddef5b8b99373</citedby><cites>FETCH-LOGICAL-c623t-5499d3ab4784401ad2ca4c10976c11853c09c0a12b414047e757ddef5b8b99373</cites><orcidid>0000-0002-6707-9521</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10313051/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10313051/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793,79600,79601</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37390076$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Mugauri, Hamufare Dumisani Dumisani</contributor><creatorcontrib>Yaylali, Emine</creatorcontrib><creatorcontrib>Erdogan, Zikriye Melisa</creatorcontrib><creatorcontrib>Calisir, Fethi</creatorcontrib><creatorcontrib>Gokengin, Deniz</creatorcontrib><creatorcontrib>Korten, Volkan</creatorcontrib><creatorcontrib>Tabak, Fehmi</creatorcontrib><creatorcontrib>Tasova, Yesim</creatorcontrib><creatorcontrib>Unal, Serhat</creatorcontrib><creatorcontrib>Ozelgun, Berna</creatorcontrib><creatorcontrib>Ozcagli, Tahsin Gokcem</creatorcontrib><creatorcontrib>Sahin, Toros</creatorcontrib><title>Modeling the future of HIV in Turkey: Cost-effectiveness analysis of improving testing and diagnosis</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>This study aimed to determine HIV incidence and prevalence in Turkey and to estimate the cost-effectiveness of improving testing and diagnosis in the next 20 years.
HIV incidence in Turkey has been rapidly increasing in the last decade with a particularly high rate of infection for younger populations, which underscores the urgent need for a robust prevention program and improved testing capacity for HIV.
We developed a dynamic compartmental model of HIV transmission and progression among the Turkish population aged 15-64 and assessed the effect of improving testing and diagnosis. The model generated the number of new HIV cases by transmission risk and CD4 level, HIV diagnoses, HIV prevalence, continuum of care, the number of HIV-related deaths, and the expected number of infections prevented from 2020 to 2040. We also explored the cost impact of HIV and the cost-effectiveness of improving testing and diagnosis.
Under the base case scenario, the model estimated an HIV incidence of 13,462 cases in 2020, with 63% undiagnosed. The number of infections was estimated to increase by 27% by 2040, with HIV incidence in 2040 reaching 376,889 and HIV prevalence 2,414,965 cases. Improving testing and diagnosis to 50%, 70%, and 90%, would prevent 782,789, 2,059,399, and 2,336,564 infections-32%, 85%, and 97% reduction in 20 years, respectively. Improved testing and diagnosis would reduce spending between $1.8 and $8.8 billion.
In the case of no improvement in the current continuum of care, HIV incidence and prevalence will significantly increase over the next 20 years, placing a significant burden on the Turkish healthcare system. However, improving testing and diagnosis could substantially reduce the number of infections, ameliorating the public health and disease burden aspects.</description><subject>Acquired immune deficiency syndrome</subject><subject>AIDS</subject><subject>Analysis</subject><subject>Antiretroviral drugs</subject><subject>Biology and Life Sciences</subject><subject>Care and treatment</subject><subject>CD4 antigen</subject><subject>Cost analysis</subject><subject>Cost benefit analysis</subject><subject>Cost of Illness</subject><subject>Cost-Effectiveness Analysis</subject><subject>Diagnosis</subject><subject>Disease prevention</subject><subject>Disease transmission</subject><subject>Economic aspects</subject><subject>Effectiveness</subject><subject>Epidemics</subject><subject>Epidemiological Models</subject><subject>Epidemiology</subject><subject>Evaluation</subject><subject>Health aspects</subject><subject>Health care reform</subject><subject>Heterosexuality</subject><subject>HIV</subject><subject>HIV (Viruses)</subject><subject>HIV Infections - diagnosis</subject><subject>HIV Infections - epidemiology</subject><subject>HIV testing</subject><subject>HIV-2</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Infection</subject><subject>Infectious diseases</subject><subject>Management</subject><subject>Medical care, Cost of</subject><subject>Medical diagnosis</subject><subject>Medical research</subject><subject>Medicine and health sciences</subject><subject>Medicine, Experimental</subject><subject>Modelling</subject><subject>Mortality</subject><subject>Patients</subject><subject>People and Places</subject><subject>Pharmacy</subject><subject>Population</subject><subject>Prevention</subject><subject>Public health</subject><subject>Turkey - 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one</jtitle><addtitle>PLoS One</addtitle><date>2023-06-30</date><risdate>2023</risdate><volume>18</volume><issue>6</issue><spage>e0286254</spage><epage>e0286254</epage><pages>e0286254-e0286254</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>This study aimed to determine HIV incidence and prevalence in Turkey and to estimate the cost-effectiveness of improving testing and diagnosis in the next 20 years.
HIV incidence in Turkey has been rapidly increasing in the last decade with a particularly high rate of infection for younger populations, which underscores the urgent need for a robust prevention program and improved testing capacity for HIV.
We developed a dynamic compartmental model of HIV transmission and progression among the Turkish population aged 15-64 and assessed the effect of improving testing and diagnosis. The model generated the number of new HIV cases by transmission risk and CD4 level, HIV diagnoses, HIV prevalence, continuum of care, the number of HIV-related deaths, and the expected number of infections prevented from 2020 to 2040. We also explored the cost impact of HIV and the cost-effectiveness of improving testing and diagnosis.
Under the base case scenario, the model estimated an HIV incidence of 13,462 cases in 2020, with 63% undiagnosed. The number of infections was estimated to increase by 27% by 2040, with HIV incidence in 2040 reaching 376,889 and HIV prevalence 2,414,965 cases. Improving testing and diagnosis to 50%, 70%, and 90%, would prevent 782,789, 2,059,399, and 2,336,564 infections-32%, 85%, and 97% reduction in 20 years, respectively. Improved testing and diagnosis would reduce spending between $1.8 and $8.8 billion.
In the case of no improvement in the current continuum of care, HIV incidence and prevalence will significantly increase over the next 20 years, placing a significant burden on the Turkish healthcare system. However, improving testing and diagnosis could substantially reduce the number of infections, ameliorating the public health and disease burden aspects.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>37390076</pmid><doi>10.1371/journal.pone.0286254</doi><tpages>e0286254</tpages><orcidid>https://orcid.org/0000-0002-6707-9521</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2023-06, Vol.18 (6), p.e0286254-e0286254 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_2831772563 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS) Journals Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Acquired immune deficiency syndrome AIDS Analysis Antiretroviral drugs Biology and Life Sciences Care and treatment CD4 antigen Cost analysis Cost benefit analysis Cost of Illness Cost-Effectiveness Analysis Diagnosis Disease prevention Disease transmission Economic aspects Effectiveness Epidemics Epidemiological Models Epidemiology Evaluation Health aspects Health care reform Heterosexuality HIV HIV (Viruses) HIV Infections - diagnosis HIV Infections - epidemiology HIV testing HIV-2 Human immunodeficiency virus Humans Infection Infectious diseases Management Medical care, Cost of Medical diagnosis Medical research Medicine and health sciences Medicine, Experimental Modelling Mortality Patients People and Places Pharmacy Population Prevention Public health Turkey - epidemiology |
| title | Modeling the future of HIV in Turkey: Cost-effectiveness analysis of improving testing and diagnosis |
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