Table 2. Base case results.* .
| Single Interventions | Dual Interventions | All Interventions | ||||||||||
| Outcome Measures | Status Quo | 25% PrEP | 50% PrEP | ART | MMT | MMT, 25% PrEP | MMT, 50% PrEP | MMT, ART | ART, 25% PrEP | ART, 50% PrEP | MMT, ART, 25% PrEP | MMT, ART, 50% PrEP |
| Number of individuals reached by each intervention over 20 yrs** | ||||||||||||
| PrEP | 0 | 13,686 | 20,671 | 0 | 0 | 16,010 | 23,012 | 0 | 14,506 | 21,655 | 16,645 | 23,724 |
| MMT | 0 | 0 | 0 | 0 | 50,486 | 50,060 | 49,879 | 49,857 | 0 | 0 | 49,536 | 49,403 |
| ART | 10,620 | 10,166 | 9928 | 39,702 | 13,283 | 12,317 | 11,891 | 36,195 | 36,736 | 35,248 | 33,046 | 31,673 |
| HIV prevalence after 20 yrs | ||||||||||||
| Among IDUs | 67.2% | 57.0% | 51.5% | 66.8% | 53.0% | 39.3% | 33.9% | 53.5% | 55.8% | 50.3% | 39.5% | 34.2% |
| Among non-IDUs | 0.91% | 0.83% | 0.79% | 0.89% | 0.83% | 0.73% | 0.68% | 0.83% | 0.81% | 0.77% | 0.73% | 0.69% |
| Overall | 1.47% | 1.34% | 1.26% | 1.50% | 1.32% | 1.11% | 1.03% | 1.36% | 1.35% | 1.27% | 1.14% | 1.05% |
| Infections averted | ||||||||||||
| Among IDUs | 0 | 2355 | 3636 | 757 | 2982 | 6043 | 7384 | 3672 | 3308 | 775 | 6799 | 8115 |
| Among non-IDUs | 0 | 1196 | 1828 | 3179 | 1741 | 3087 | 3688 | 4492 | 4240 | 4539 | 5653 | 6152 |
| Total | 0 | 3552 | 5464 | 3935 | 4723 | 9130 | 11,072 | 8164 | 7548 | 9401 | 12,453 | 14,267 |
| Incremental QALYS and cost*** | ||||||||||||
| QALYs | – | 29,294 | 44,963 | 96,323 | 75,458 | 111,032 | 127,018 | 163,772 | 122,422 | 135,821 | 194,720 | 208,102 |
| Cost (US 1000s) | – | $40,405 | $63,430 | $94,864 | $39,018 | $106,937 | $139,009 | $127,788 | $134,871 | $157,026 | $194,723 | $225,521 |
The table presents undiscounted HIV infections averted, and discounted QALYs and costs (discounted to the present at 3% annually). IDU = injection drug user; PrEP = oral pre-exposure prophylaxis for injection drug users; ART = antiretroviral therapy for 80% of eligible individuals; MMT = methadone maintenance treatment for 25% of IDUs; 25% PrEP = PrEP for 25% of uninfected IDUs; 50% PrEP = PrEP for 50% of uninfected IDUs.
The numbers for similar strategies vary because of dynamics. For example, for the strategy “25% PrEP,” 13,686 IDUs receive PrEP, whereas for the strategy “ART, 25% PrEP,” 14,506 IDUs receive PrEP; this is because with scaled up ART, IDUs live longer, so 25% of IDUs on PrEP with ART scale up is greater than 25% of IDUs on PrEP without ART scale up.
Incremental to the status quo.