title: Unmet HIV Service Needs Among Hispanic Men who Have Sex with Men in the United States.
abstract: The National HIV/AIDS Strategy (NHAS) originally issued in 2010 targets the reduction of HIV-related health disparities. Hispanic men who have sex with men (MSM) have the third highest burden of incident HIV in the US, but there are no estimates of the unmet HIV service needs for Hispanic MSM. We estimate that of approximately 204,800 Hispanic MSM living with HIV, roughly 46,900 were undiagnosed. 157,900 were diagnosed, and of those, 75,700 were not linked to care and 82,200 were linked. Among diagnosed individuals, 48,800 had undetectable viral loads, and 109,100 had detectable viral loads. An estimated 30,000 of diagnosed Hispanic MSM engage in unprotected, serodiscordant risk behaviors. Total cost to meet service needs and achieve NHAS goals is ~$2.511 billion in 2011 US dollars. Transmission rate modeling suggests this investment would avert 3656 new HIV infections at an economically favorable cost of $61,202 per quality-adjusted life year saved.
authors.affiliation: MPH Program, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. rbonacci@upenn.edu.|Perelman School of Medicine, Jordan Medical Education Center, University of Pennsylvania, 6th Floor, 3400 Civic Center Blvd, Building 421, Philadelphia, PA, 19104-5162, USA. rbonacci@upenn.edu.
authors.forename: Robert A
authors.identifier: 0000-0002-7989-2093
authors.initials: RA
authors.lastname: Bonacci
authors.affiliation: Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: David R
authors.initials: DR
authors.lastname: Holtgrave
mesh_terms: D015492:AIDS Serodiagnosis / Q000191:economics / Q000706:statistics & numerical data; D000328:Adult; D019380:Anti-HIV Agents / Q000191:economics / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D015658:HIV Infections / Q000188:drug therapy* / Q000191:economics / Q000208:ethnology / Q000821:virology; D006301:Health Services Needs and Demand / Q000191:economics; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D018451:Homosexuality, Male / Q000208:ethnology* / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000191:economics / Q000706:statistics & numerical data; D015233:Models, Statistical; D019057:Quality-Adjusted Life Years; D012309:Risk-Taking; D014481:United States / Q000453:epidemiology; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents
keywords: Economic evaluation; HIV; Hispanic; Latino; MSM; Mathematical modeling; Policy analysis