Current Efforts

This effort seeks to utilize agent-based epidemic modeling to quantify the effect of integrated testing for HIV and STI in the era of PrEP. The CDC recommends routine STI screening (syphilis, gonorrhea, chlamydia) alongside HIV testing in many contexts, especially for sexually active MSM (at least annually, or every 3–6 months if high risk), people diagnosed with HIV, and people starting PrEP. However, testing for STIs is not automatically bundled with HIV testing nor is HIV testing automatically bundled with STI diagnoses. Recent studies have reported that integrated testing for STIs was only conducted for 69% of individual on PrEP when testing for HIV and 39% of individuals not on PrEP when testing for HIV. Similarly, a study evaluating HIV testing following STI testing and diagnosis found that overall only 43% of all STI-diagnosed study participants were screened for HIV. The lack of integrated testing across HIV/STI is potentially a significant missed opportunity for the identification and treatment of ongoing infections. Mathematical modeling can provide estimates for the number of infections of each type that may be averted through the implementation of alternative joint-testing strategies. In this study we will simulate the implementation of STI testing in conjunction with all HIV tests administered for PrEP enrollment and ongoing utilization among MSM as well as the implementation of HIV testing in conjunction with all STI diagnoses. 

In 2020, CDC released updated recommendations regarding testing for hepatitis C virus (HCV) infection in the United States. The update included a new recommendation for hepatitis C screening at least once in a lifetime for all adults aged 18 years or older. Despite the updated recommendation, HCV screening among adults remains low.  The overarching goal of this project will be to model how increasing screening levels of the U.S. adult population could affect population health and economic outcomes. These results will help public health institutions determine HCV screening targets for for viral hepatitis elimination plans.

This multi-year research effort seeks to collect and analyze patient-side costs of TB treatment for purposes of estimating the cost of TB treatment per person in the United States.  CAMP will partner with three public health jurisdictions (GA, MD, and NYC) to collect cost data from persons being treated for TB in public health clinics. 

The per-person cost of TB (including pre-diagnosis, diagnosis, and treatment) in the United States has not been systematically estimated in nearly a decade - and is critical in resource allocation decisions. For example, in recommending TB preventive treatment, it is important to know the monetary savings that accrue from preventing a single TB disease episode. An essential component of that estimate is the cost from the patient perspective - as patients are often at financial risk before developing TB, and the costs of TB care can be catastrophic. These results will enable more evidence-based decision-making and facilitate future advocacy efforts as we seek to demonstrate the financial value of efforts to end TB in the US.

This project aims to produce updated, high-resolution population size estimates for people who inject drugs (PWID) across the United States. By leveraging advanced statistical frameworks, the initiative will provide critical data to inform public health resource allocation, harm reduction strategies, and infectious disease modeling at both the national and state levels (including the District of Columbia).