$36.4 billion a year: Cost of HIV/AIDS highlights racial and ethnic disparities

September 22, 2006

ATLANTA--The economic cost of HIV/AIDS is far greater than previously estimated, and the cost is even higher for minorities, according to a new study that estimated the direct and indirect costs of the disease. The total lifetime cost of illness for Americans newly diagnosed with HIV in 2002 is approximately $36.4 billion, of which more than 80 percent is related to productivity losses, a cost that most previous studies have omitted. The study also reveals that while the direct costs of antiretroviral therapy may be high, these costs are eventually offset by extended productivity. The research shows that differences in medical care result in dissimilar costs -- both direct and indirect -- among different racial and ethnic groups.

The study is published on-line in the Journal of Acquired Immune Deficiency Syndromes (JAIDS), ahead of print publication. It is the result of collaboration among researchers at the Centers for Disease Control and Prevention (CDC), the Emory University Center for AIDS Research, and the Andrew Young School of Policy Studies at Georgia State University.

An estimated 40,000 people in the United States become infected with HIV each year. While researchers have previously estimated the economic costs of HIV/AIDS, they have focused primarily on the direct medical expenses of treating the disease. The results up to now have given an incomplete picture of the disease's economic consequences, according to Angela Blair Hutchinson, PhD, MPH, a health economist at the CDC and lead author of the paper.

"We wanted to assess the economic burden of an HIV infection in the U.S.," says Dr. Hutchinson, "by examining the impact of stage of disease at diagnosis and access to treatment on the cost of HIV infection and how this might differ by race/ethnicity."

The research shows that differences in medical care result in dissimilar costs--both direct and indirect Ð for various racial/ethnic groups. "We found that direct costs were lower and productivity losses were higher for minorities," says Dr. Hutchinson.

Specifically, minorities incur fewer direct medical costs than whites ($160,400 for blacks on average, compared with $180,900 for whites), but suffer greater financial damage from lost productivity ($838,000 for Hispanics and $766,800 for blacks on average, compared with $661,100 for whites).

The differences, according to Hutchinson, reflect disparities in treatment. Minorities are, on average, diagnosed at later stages of the disease than whites. In addition, whites with HIV/AIDS are more likely to receive antiretroviral therapy (ART).

As Dr. Hutchinson notes, "ART is not used universally because it is expensive. Many patients with HIV/AIDS do not have health insurance and/or do not have access to ART."

Though ART is costly, it has proven very effective at extending lives, and productivity. The researchers found that ART patients have direct medical costs averaging $230,044, with a projected life expectancy of 24.4 years. Patients not receiving ART have direct medical costs of approximately $114,938, with a projected life expectancy of 12.4 years.

The additional years of productivity after being treated with ART mean that the more expensive treatment is actually more cost effective in the long run. "Universal access to treatment would be cost saving," says Dr. Paul Farnham, a co-author and economist from the Andrew Young School of Policy Studies at Georgia State University, "because it decreases the years of life lost from the illness, and thus lowers productivity losses more than it increases the direct medical costs."

Besides recommending such universal access, the paper also emphasizes the importance of diagnosing the disease early. As Dr. Hutchinson explains, in order to narrow the treatment divide and expense gap among racial/ethnic groups with HIV/AIDS, "There needs to be a focus on earlier diagnosis, particularly for minorities."
The study's co-authors are Paul G. Farnham, PhD, Georgia State University; Carlos del Rio, MD, Emory University Center for AIDS Research; and Hazel D. Dean, ScD, MPH, Donatus U. Ekwueme, PhD, Laurie Kamimoto, MD, MPH, and Scott E. Kellerman, MD, MPH of the CDC.

Emory University Health Sciences Center

Related HIV Articles from Brightsurf:

BEAT-HIV Delaney collaboratory issues recommendations measuring persistent HIV reservoirs
Spearheaded by Wistar scientists, top worldwide HIV researchers from the BEAT-HIV Martin Delaney Collaboratory to Cure HIV-1 Infection by Combination Immunotherapy (BEAT-HIV Collaboratory) compiled the first comprehensive set of recommendations on how to best measure the size of persistent HIV reservoirs during cure-directed clinical studies.

The Lancet HIV: Study suggests a second patient has been cured of HIV
A study of the second HIV patient to undergo successful stem cell transplantation from donors with a HIV-resistant gene, finds that there was no active viral infection in the patient's blood 30 months after they stopped anti-retroviral therapy, according to a case report published in The Lancet HIV journal and presented at CROI (Conference on Retroviruses and Opportunistic Infections).

Children with HIV score below HIV-negative peers in cognitive, motor function tests
Children who acquired HIV in utero or during birth or breastfeeding did not perform as well as their peers who do not have HIV on tests measuring cognitive ability, motor function and attention, according to a report published online today in Clinical Infectious Diseases.

Efforts to end the HIV epidemic must not ignore people already living with HIV
Efforts to prevent new HIV transmissions in the US must be accompanied by addressing HIV-associated comorbidities to improve the health of people already living with HIV, NIH experts assert in the third of a series of JAMA commentaries.

The Lancet HIV: Severe anti-LGBT legislations associated with lower testing and awareness of HIV in African countries
This first systematic review to investigate HIV testing, treatment and viral suppression in men who have sex with men in Africa finds that among the most recent studies (conducted after 2011) only half of men have been tested for HIV in the past 12 months.

The Lancet HIV: Tenfold increase in number of adolescents on HIV treatment in South Africa since 2010, but many still untreated
A new study of more than 700,000 one to 19-year olds being treated for HIV infection suggests a ten-fold increase in the number of adolescents aged 15 to 19 receiving HIV treatment in South Africa, according to results published in The Lancet HIV journal.

Starting HIV treatment in ERs may be key to ending HIV spread worldwide
In a follow-up study conducted in South Africa, Johns Hopkins Medicine researchers say they have evidence that hospital emergency departments (EDs) worldwide may be key strategic settings for curbing the spread of HIV infections in hard-to-reach populations if the EDs jump-start treatment and case management as well as diagnosis of the disease.

NIH HIV experts prioritize research to achieve sustained ART-free HIV remission
Achieving sustained remission of HIV without life-long antiretroviral therapy (ART) is a top HIV research priority, according to a new commentary in JAMA by experts at the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health.

The Lancet HIV: PrEP implementation is associated with a rapid decline in new HIV infections
Study from Australia is the first to evaluate a population-level roll-out of pre-exposure prophylaxis (PrEP) in men who have sex with men.

Researchers date 'hibernating' HIV strains, advancing BC's leadership in HIV cure research
Researchers have developed a novel way for dating 'hibernating' HIV strains, in an advancement for HIV cure research.

Read More: HIV News and HIV Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.