Early Treatment of HIV: Benefits Gained, and Missed Opportunities

March 21, 2014

(AUDIO) How many lives have been saved due to early treatment of HIV infection, and what is the impact on society? An economist who has helped to answer these questions also ponders the deeper implications of the new information about progress against HIV.

In 1996 and again in 2009, guidelines moved the standard of HIV treatment to mandate responses earlier in the disease. Research documents that this has saved lives -- but how many altogether, and what has been the impact on society?

In this recorded interview, economist John A. Romley PhD addresses this question as he describes a new study that reveals the number of cases prevented by these new guidelines, and the tremendous benefit in lives -- and in dollars -- reaped from this change in medical practice.

Dr. Romley is research assistant professor of public policy at the University of Southern California.

The questions:

Why don't we just start with you telling us about this study and what impelled it?

You turned the numbers into dollars and showed us the savings to the health care system. Tell us about that.

You're putting numbers to it, putting a face to it, so to speak ...

Key quotes:

•  As we look forward we want to understand what were the opportunities that were realized, what opportunities might not have been realized and what should the future look like?

•  What we found was that nearly 188,000 infections did not occur because some people with HIV over that period actually started treatment early.

•  It's key to recognize how important treatment in general and early treatment in particular ... could be and in fact have been in terms of preventing new cases in the United States.

•  For each case of HIV that's prevented, it's worth more than $600,000 to that person who didn't get HIV. ... Aggregating up, the number comes out to about $128 billion. That's a lot of money. That's a lot of value.


Goldman DP, Juday T, Seekins D et al.Early HIV Treatment In The United States Prevented Nearly 13,500 Infections Per Year During 1996–2009Health Affairs (2014) 33:428-433. doi: 10.1377/hlthaff.2013.1280.