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OP535 Cost-Effectiveness Of Internet-Based HIV Screening In Men Who Have Sex With Men in Vancouver, British Columbia, Canada
- Wei Zhang, José de Anda, Michael Irvine, Hsiu-Ju Chang, Mark Gilbert
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- Journal:
- International Journal of Technology Assessment in Health Care / Volume 36 / Issue S1 / December 2020
- Published online by Cambridge University Press:
- 28 December 2020, pp. 13-14
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Introduction
In Canada, individuals test for HIV commonly through clinic-based screening services (CBSS). However, gay, bisexual and other men who have sex with men (GBMSM) may face barriers accessing such services due to, for example, feeling discomfort disclosing their sexual history or fearing judgment from healthcare providers. To reduce barriers and increase uptake and frequency of screening for sexually-transmitted infections (STIs) including HIV, the British Columbia Centre for Disease Control implemented an internet-based screening service, GetCheckedOnline.com (GCO), in September 2014 in Vancouver, Canada. We assessed the cost-effectiveness of GCO at different uptake scenarios compared to CBSS in Vancouver GBMSM.
MethodsCost-utility analyses were conducted from a healthcare payer's perspective using an established dynamic GBMSM HIV compartmental model. The model estimated the probability of becoming infected with HIV, progressing through diagnosis, disease stages, and treatment over a 30-year time horizon. The base case assumed 4.7 percent uptake of GCO, and 74 percent of high-risk and 44 percent of low-risk infrequent testers becoming regular testers in five years. Scenario analyses tested GCO 10 and 15 percent uptakes.
ResultsCompared with the conventional CBSS alone, a 4.7 percent GCO uptake increased the costs by CAD90,059 (USD75,680; 95% confidence interval (CI): -CAD420,836, CAD273,987) and gained 3 (95% CI: 0, 6) quality-adjusted life years (QALYs) in a 30-year time horizon. There was a 71 percent probability that GCO was cost-effective at a cost-effectiveness threshold of CAD50,000 (USD42,000) per QALY. The results were consistent in other two uptake scenarios.
ConclusionsExpanding HIV screening for GBMSM through increasing uptake of GCO is a cost-effective alternative to expanding the conventional CBSS. We noted that difference in total costs might be smaller if a battery of STI tests is considered, which in turn may affect our cost-effectiveness estimate. For the next phase of cost-utility analysis, we will expand our model to include testing for other STIs.
Geographic patterns of biodiversity in European coastal marine benthos
- Herman Hummel, Pim Van Avesaath, Sander Wijnhoven, Loran Kleine-Schaars, Steven Degraer, Francis Kerckhof, Natalia Bojanic, Sanda Skejic, Olja Vidjak, Maria Rousou, Helen Orav-Kotta, Jonne Kotta, Jérôme Jourde, Maria Luiza Pedrotti, Jean-Charles Leclerc, Nathalie Simon, Fabienne Rigaut-Jalabert, Guy Bachelet, Nicolas Lavesque, Christos Arvanitidis, Christina Pavloudi, Sarah Faulwetter, Tasman Crowe, Jennifer Coughlan, Lisandro Benedetti-Cecchi, Martina Dal Bello, Paolo Magni, Serena Como, Stefania Coppa, Anda Ikauniece, Tomas Ruginis, Emilia Jankowska, Jan Marcin Weslawski, Jan Warzocha, Sławomira Gromisz, Bartosz Witalis, Teresa Silva, Pedro Ribeiro, Valentina Kirienko Fernandes De Matos, Isabel Sousa-Pinto, Puri Veiga, Jesús Troncoso, Xabier Guinda, Jose Antonio Juanes De La Pena, Araceli Puente, Free Espinosa, Angel Pérez-Ruzafa, Matt Frost, Caroline Louise Mcneill, Ohad Peleg, Gil Rilov
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- Journal:
- Journal of the Marine Biological Association of the United Kingdom / Volume 97 / Issue 3 / May 2017
- Published online by Cambridge University Press:
- 14 September 2016, pp. 507-523
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Within the COST action EMBOS (European Marine Biodiversity Observatory System) the degree and variation of the diversity and densities of soft-bottom communities from the lower intertidal or the shallow subtidal was measured at 28 marine sites along the European coastline (Baltic, Atlantic, Mediterranean) using jointly agreed and harmonized protocols, tools and indicators. The hypothesis tested was that the diversity for all taxonomic groups would decrease with increasing latitude. The EMBOS system delivered accurate and comparable data on the diversity and densities of the soft sediment macrozoobenthic community over a large-scale gradient along the European coastline. In contrast to general biogeographic theory, species diversity showed no linear relationship with latitude, yet a bell-shaped relation was found. The diversity and densities of benthos were mostly positively correlated with environmental factors such as temperature, salinity, mud and organic matter content in sediment, or wave height, and related with location characteristics such as system type (lagoons, estuaries, open coast) or stratum (intertidal, subtidal). For some relationships, a maximum (e.g. temperature from 15–20°C; mud content of sediment around 40%) or bimodal curve (e.g. salinity) was found. In lagoons the densities were twice higher than in other locations, and at open coasts the diversity was much lower than in other locations. We conclude that latitudinal trends and regional differences in diversity and densities are strongly influenced by, i.e. merely the result of, particular sets and ranges of environmental factors and location characteristics specific to certain areas, such as the Baltic, with typical salinity clines (favouring insects) and the Mediterranean, with higher temperatures (favouring crustaceans). Therefore, eventual trends with latitude are primarily indirect and so can be overcome by local variation of environmental factors.