Projected Life Expectancy Gains From Improvements in HIV Care in Black and White Men Who Have Sex With Men Article Swipe
Katherine M. Rich
,
Apurvakumar Pandya
,
John J. Chiosi
,
Krishna P. Reddy
,
Fatma M. Shebl
,
Andrea Ciaranello
,
Anne M. Neilan
,
Jodian Pinkney
,
Elena Losina
,
Kenneth A. Freedberg
,
Aima A. Ahonkhai
,
Emily P. Hyle
·
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1001/jamanetworkopen.2023.44385
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1001/jamanetworkopen.2023.44385
Importance Substantial racial inequities exist across the HIV care continuum between non-Hispanic Black and White men who have sex with men (MSM) in the US. Objectives To project years of life gained (YLG) with improving the HIV care continuum among Black MSM and White MSM in the US and to determine the outcomes of achieving health equity goals. Design, Setting, and Participants The Cost-Effectiveness of Preventing AIDS Complications microsimulation model was used and populated with 2021 race-specific data to simulate HIV care among Black MSM and White MSM in the US who have acquired HIV. Analyses were completed from July 2021 to October 2023. Intervention The study simulated status quo care using race-specific estimates: age at infection, time to diagnosis, receipt of care, and virologic suppression. The study next projected the outcomes of attaining equity-centered vs non–equity-centered goals by simulating 2 equal improvements in care goals: (10-point increased receipt of care and 5-point increased virologic suppression), 3 equity-centered goals (annual HIV testing, 95% receiving HIV care, and 95% virologic suppression) and lastly, an equitable care continuum that achieves annual HIV testing, 95% receiving care, and 95% virologic suppression in Black MSM and White MSM. One-way and multiway sensitivity and scenario analyses were conducted. Main Outcomes and Measures Mean age at death and YLG. Results In the simulated cohort, the mean (SD) age at HIV infection was 27.0 (10.8) years for Black MSM and 35.5 (13.6) years for White MSM. In status quo, mean age at death would be 68.8 years for Black MSM and 75.6 years for White MSM. The equal improvements in care goals would result in 0.5 YLG for Black MSM and 0.5 to 0.9 YLG for White MSM. Achieving any 1 equity-centered goal would result in 0.5 to 1.7 YLG for Black MSM and 0.4 to 1.3 YLG for White MSM. With an equitable care continuum compared with the nationally reported status quo , Black MSM and White MSM would gain 3.5 and 2.1 life-years, respectively. If the status quo HIV testing was every 6 years with 75% retained in care and 75% virologically suppressed, Black MSM would gain 4.2 life-years with an equitable care continuum . Conclusions and Relevance In this simulation modeling study of HIV care goals, equal improvements in HIV care for Black and White MSM maintained or worsened inequities. These results suggest that equity-centered goals for the HIV care continuum are critical to mitigate long-standing inequities in HIV outcomes.
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- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1001/jamanetworkopen.2023.44385
- https://jamanetwork.com/journals/jamanetworkopen/articlepdf/2812252/rich_2023_oi_231293_1700081688.2761.pdf
- OA Status
- gold
- Cited By
- 3
- References
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- Related Works
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- OpenAlex ID
- https://openalex.org/W4389082622
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4389082622Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1001/jamanetworkopen.2023.44385Digital Object Identifier
- Title
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Projected Life Expectancy Gains From Improvements in HIV Care in Black and White Men Who Have Sex With MenWork title
- Type
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articleOpenAlex work type
- Language
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enPrimary language
- Publication year
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2023Year of publication
- Publication date
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2023-11-28Full publication date if available
- Authors
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Katherine M. Rich, Apurvakumar Pandya, John J. Chiosi, Krishna P. Reddy, Fatma M. Shebl, Andrea Ciaranello, Anne M. Neilan, Jodian Pinkney, Elena Losina, Kenneth A. Freedberg, Aima A. Ahonkhai, Emily P. HyleList of authors in order
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https://doi.org/10.1001/jamanetworkopen.2023.44385Publisher landing page
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https://jamanetwork.com/journals/jamanetworkopen/articlepdf/2812252/rich_2023_oi_231293_1700081688.2761.pdfDirect link to full text PDF
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YesWhether a free full text is available
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goldOpen access status per OpenAlex
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https://jamanetwork.com/journals/jamanetworkopen/articlepdf/2812252/rich_2023_oi_231293_1700081688.2761.pdfDirect OA link when available
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Men who have sex with men, Demography, Medicine, Life expectancy, Cohort, Gerontology, Receipt, Health care, Human immunodeficiency virus (HIV), Environmental health, Family medicine, Population, Internal medicine, Political science, Sociology, Law, World Wide Web, Syphilis, Computer scienceTop concepts (fields/topics) attached by OpenAlex
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3Total citation count in OpenAlex
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2025: 2, 2024: 1Per-year citation counts (last 5 years)
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