Sexually Transmitted Disease Prevention in Gay Population
Sexually transmitted diseases, especially AIDS, have continued to pose a threat of unprecedented magnitude to the gay population in the United States (Beyrer et al. 2012). A public health initiative is to refocus the efforts on reducing new STD infections by ensuring that the gay population who test HIV positive receive care and treatment to eradicate the epidemic. However, the treatment as prevention of HIV among the gay population is faced with several challenges (Wilson, 2012). For instance, to successfully lower the community viral load requires a torrent of interconnected events such as diagnosing a high number of HIV-positive individuals, linking them into care, retaining the care, initiating on ART, continuing ART treatment over time, as well as support to them to successfully adhere to a treatment regimen. It is quite difficult to achieve the sequence of such events. Secondly, linking HIV positive gay people to care and maintaining adherence to treatment is also an increasing challenge to treatment as prevention of HIV among the gay population (Wilson, 2012).
Analyzing the cost-benefit or return on investment on treatment as prevention initiative to prevent the spread of HIV among the gay people shows that the initiative is justifiable. This is because the money that will be used to reach the gay people infected with HIV is less compared to the benefit of saving others in the society who are exposed and at risk of getting infected (Getzen, 2013). Besides, the cost of ensuring the treatment as prevention cascade would ultimately yield a considerable decline in community viral load meaning that financing the initiative is worthwhile. According to Richard, West & Ku (2012), if an initiative has more benefits that cost or has a high return on investment, then investing in such a project is justifiable. Besides, with the increased health care costs, making it possible to access care among the gay population may encourage others to seek treatment (Ginsburg, 2008).
Beyrer, C., Baral, S. D., Van Griensven, F., Goodreau, S. M., Chariyalertsak, S., Wirtz, A. L., & Brookmeyer, R. (2012). Global epidemiology of HIV infection in men who have sex with men. The Lancet, 380(9839), 367-377.
Getzen, T. E. (2013). Health economics and financing (5th ed.). Hoboken, NJ: John Wiley and Sons.
Ginsburg, P. B. (2008). High and rising health care costs: Demystifying US health care spending (The Robert Wood Johnson Foundation, Report No. 16). Retrieved from: https://www2.cbia.com/ieb/ag/CostOfCare/RisingCosts/RobertWood_HighRisingHealthCareCost.pdf
Richard, P. West, K., & Ku, L. (2012). The return on investment of a Medicaid tobacco cessation program in Massachusetts. Plos one, 7(1). Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3253087/?tool=pubmed
Wilson, D. P. (2012). HIV treatment as prevention: natural experiments highlight limits of antiretroviral treatment as HIV prevention. PLoS Med, 9(7), e1001231.