title: Partner Notification for Reduction of HIV-1 Transmission and Related Costs among Men Who Have Sex with Men: A Mathematical Modeling Study.
abstract: BACKGROUND
  Earlier antiretroviral treatment initiation prevents new HIV infections. A key problem in HIV prevention and care is the high number of patients diagnosed late, as these undiagnosed patients can continue forward HIV transmission. We modeled the impact on the Dutch men-who-have-sex-with-men (MSM) HIV epidemic and cost-effectiveness of an existing partner notification process for earlier identification of HIV-infected individuals to reduce HIV transmission.
  
  
  METHODS
  Reduction in new infections and cost-effectiveness ratios were obtained for the use of partner notification to identify 5% of all new diagnoses (Scenario 1) and 20% of all new diagnoses (Scenario 2), versus no partner notification. Costs and quality adjusted life years (QALYs) were assigned to each disease state and calculated over 5 year increments for a 20 year period.
  
  
  RESULTS
  Partner notification is predicted to avert 18-69 infections (interquartile range [IQR] 13-24; 51-93) over the course of 5 years countrywide to 221-830 (IQR 140-299; 530-1,127) over 20 years for Scenario 1 and 2 respectively. Partner notification was considered cost-effective in the short term, with increasing cost-effectiveness over time: from €41,476 -€41, 736 (IQR €40,529-€42,147; €40,791-€42,397) to €5,773 -€5,887 (€5,134-€7,196; €5,411-€6,552) per QALY gained over a 5 and 20 year period, respectively. The full monetary benefits of partner notification by preventing new HIV infections become more apparent over time.
  
  
  CONCLUSIONS
  Partner notification will not lead to the end of the HIV epidemic, but will prevent new infections and be increasingly cost-effectiveness over time.
authors.affiliation: Department of Viroscience, Erasmus Medical Center, Rotterdam, the Netherlands.
authors.forename: Brooke E
authors.initials: BE
authors.lastname: Nichols
authors.affiliation: Department Infectious Disease Control, Public Health Service Rotterdam-Rijnmond, Rotterdam, the Netherlands.|Department of Public Health, Erasmus Medical Center, Rotterdam, the Netherlands.
authors.forename: Hannelore M
authors.initials: HM
authors.lastname: Götz
authors.affiliation: Department of Viroscience, Erasmus Medical Center, Rotterdam, the Netherlands.|Department of Internal Medicine and Infectious Diseases, Erasmus Medical Center, Rotterdam, the Netherlands.
authors.forename: Eric C M
authors.initials: EC
authors.lastname: van Gorp
authors.affiliation: Department of Internal Medicine and Infectious Diseases, Erasmus Medical Center, Rotterdam, the Netherlands.
authors.forename: Annelies
authors.initials: A
authors.lastname: Verbon
authors.affiliation: Department of Internal Medicine and Infectious Diseases, Erasmus Medical Center, Rotterdam, the Netherlands.
authors.forename: Casper
authors.initials: C
authors.lastname: Rokx
authors.affiliation: Department of Viroscience, Erasmus Medical Center, Rotterdam, the Netherlands.
authors.forename: Charles A B
authors.initials: CA
authors.lastname: Boucher
authors.affiliation: Department of Viroscience, Erasmus Medical Center, Rotterdam, the Netherlands.
authors.forename: David A M C
authors.initials: DA
authors.lastname: van de Vijver
mesh_terms: D000328:Adult; D016358:Contact Tracing / Q000191:economics*; D003362:Cost-Benefit Analysis; D015658:HIV Infections / Q000191:economics / Q000517:prevention & control* / Q000635:transmission*; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008962:Models, Theoretical; D009426:Netherlands; D019057:Quality-Adjusted Life Years; D040242:Risk Reduction Behavior; D012747:Sexual Partners