Retention in HIV Care: Cost-effectiveness and Socioeconomic Support Services in Minnesota

Presented by Margo Wheatley, MS
HSRP&A Doctoral Candidate
Division of Health Policy & Management

There is still no cure for human immunodeficiency virus (HIV), meaning infected individuals must remain on lifelong treatment. While the United States has made substantial progress on HIV prevention, there are still more than 1.2 million people living with HIV (PLWH) in the US and prevalence continues to increase. Treatment not only extends life expectancy and improves quality of life for PLWH, it also reduces the risk of HIV transmission by suppressing HIV viral loads to undetectable levels. However, only 58% of diagnosed PLWH in the US were retained in care and only 66% were virally suppressed in 2019, which is well-below the national goal of reaching 95% viral suppression by 2030.

Budgets to improve HIV care are limited, making cost-effectiveness an important consideration for health departments and other decision makers. However, few cost-effectiveness analyses focus on retention in care, despite it being a critical step in the HIV care continuum from diagnosis to viral suppression. This presentation will briefly review findings from existing literature on the cost-effectiveness of retention and re-engagement in care. It will then present results on the current impact of the federal Ryan White HIV/AIDS Program services on viral suppression in the Twin Cities region as well as estimated costs for expanding these services. Finally, it will present plans for a cost-effectiveness analysis of interventions targeted at PLWH in Minnesota who are eligible for Ryan White HIV/AIDS Program services.