Table 1.
Select Model Input Parameters for an Analysis of the Impact of HIV Prevention Funding Reallocation in Tennessee
| Parameters | Populations | ||||||
|---|---|---|---|---|---|---|---|
| MSM | TGW | HSBW | First Responders | Pregnant People | Survivors of Sex Trafficking | Ref. | |
| Cohort characteristics | |||||||
| Overall population size, n | 73 639 | 11 858 | 614 218 | 23 826 | 89 412/year | NAa | [7–10] |
| Sex at birth, female/male, % | 0/100 | 0/100 | 100/0 | 27/73 | 100/0 | 93/7 | [11] |
| People with HIV, total, n | 12 680 | 1672 | 2159 | 83 | 71/y | NAa | [11, 12] |
| Prevalent undiagnosed HIV, n | 3216 | 1452 | 200 | 11 | 1/y | 46/y | |
| Incident HIV, year 2019, n | 501 | 56 | 45 | 3 | NAb | [12, 13] | |
| Age, undiagnosed population, mean (SD), y | 33 (12) | 26 (6) | 40 (14) | 35 (13) | 31 (6) | 23 (9) | [11, 12] |
| Age at HIV infection, mean (SD), y | 30 (12) | 23 (6) | 38 (14) | 32 (13) | NA | NA | |
| Mean 30-d linkage to care, % | 62 | 62 | 65 | 61 | 100 | 56 | [12] |
| CD4 at HIV infection, mean (SD), cells/μL | 667 (134) | 667 (134) | 667 (134) | 667 (134) | NAb | NAb | [6] |
| CD4 at model initiation, undiagnosed cohort, mean (SD), cells/μL | 436 (166) | 436 (166) | 436 (166) | 436 (166) | 436 (166) | 436 (166) | |
| Retention in HIV care, % in care at month 24 | 78 | 78 | 78 | 78 | 78 | 78 | [14] |
| Return to care, per 100 PY | 18.1 | 18.1 | 18.1 | 18.1 | 18.1 | 18.1 | [14] |
| ART efficacy for >91% adherence, %, range by regimen | 93–96c | 93–96c | 93–96c | 93–96c | 93–96c | 93–96c | [15, 16] |
| Intervention characteristics | |||||||
| PrEP efficacy, % | 75 | 75 | 75 | NA | NA | NA | [7] |
| Condom efficacy, % | 80 | 80 | 80 | NA | NA | NA | [17–19] |
| Baseline intervention use prevalence | |||||||
| HIV testing frequency, mean y | 4.8 | 4.8 | 2.5 | 4.4 | 4.4 | NAd | [20] |
| Condom use, % of sex acts | 45 | 45 | 49 | NA | NA | NA | [21] |
| PrEP use, % of population | 8 | 8 | 0.1 | NA | NA | NA | [22] |
| Changes in intervention use prevalence in Reallocatione | |||||||
| HIV testing frequency, % | −47 | −47 | −47 | +47 | 100f | Unchanged | [23, 24] |
| 30-d linkage to care mean, % | Unchanged | Unchanged | Unchanged | Unchanged | Unchanged | +61 | Assumed |
| Condom use, % | −4 | −4 | −4 | NA | NA | NA | [21] |
| PrEP use, % | −26 | −26 | −26 | NA | NA | NA | [22] |
Supplementary Table 1 details additional data sources and the ranges examined in sensitivity analyses. Race/ethnicity information was not provided in the references used to estimate Tennessee-specific population sizes.
Abbreviations: ART, antiretroviral therapy; HIV, human immunodeficiency virus; HSBW, heterosexual Black women; MSM, men who have sex with men; NA, not available; PrEP, HIV preexposure prophylaxis; PY, person-years; SD, standard deviation; TGW, transgender women.
a293 survivors of sex trafficking were rescued in Tennessee in 2019, as reported in National Human Trafficking Hotline, Tennessee report. See Supplementary Methods D for more details.
bIncident cohorts were not simulated for pregnant people or survivors of sex trafficking. For pregnant people, only those whose HIV was not diagnosed during their pregnancy under current allocation was included; for survivors of sex trafficking, only the yearly number of people with HIV freed from sex trafficking were included.
cART efficacy indicates mean percentage of virologically suppressed patients at 48 wk.
dSurvivors of sex trafficking were not simulated to receive regular HIV testing, assuming no testing took place before being freed from sex trafficking.
ePercent changes to intervention use prevalence in Reallocation denotes change in relation to intervention use prevalence in Current.
fPregnant people were simulated to be diagnosed immediately at model start in Reallocation.