Excess HIV Infections and Costs Associated With Reductions in HIV Prevention Services in the US

What are the likely changes in HIV transmission and health care costs if policy changes result in decreased pre-exposure prophylaxis (PrEP) use in the US?This economic evaluation estimated that if PrEP coverage declined modestly—approximately 3% annually—8618 new infections would fail to be averted in a decade, and the estimated lifetime medical costs of these infections would be $3.6 billion.These findings suggest that changes in policies, especially those that increase out-of-pocket costs of PrEP, risk reversing progress toward ending the HIV epidemic, accruing avertable HIV infections, and incurring additional costs for medical care from avoidable infections.

Corresponding Author: Patrick S. Sullivan, DVM, PhD, Department of Epidemiology, Emory University, 1518 Clifton Rd NE, Mailstop 1518-002-4AA, Atlanta, GA 30322 (pssulli@emory.edu).

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