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HIV/AIDS: Tracking Treatment

Mathematical simulation has helped shape policy about testing for and treatment of HIV/AIDS.


As some MGH researchers work to find new HIV/AIDS treatments, others study the impact of existing ones. Rochelle Walensky and Kenneth Freedberg use a mathematical simulation model called the Cost-Effectiveness of Preventing AIDS Complications (CEPAC) Model to evaluate clinical outcomes, costs and cost-effectiveness of strategies for treating HIV/AIDS and its complications. Their published analyses are influencing health policy in the United States and around the world. Here’s a sampling of their findings and the policy changes they helped effect.




Through 2004, AIDS treatment in the United States resulted in the gain of 3 million years of life. Used in Congress to motivate more funding for HIV/AIDS research.
Routine HIV testing every 5 years was found to have a cost-effectiveness ratio of $71,000 per year of life gained, whereas routine inpatient screening had a cost-effectiveness ratio of just $36,000 per life year. In 2006, helped spur change in U.S. HIV screening guidelines to recommend routine HIV screening of all patients ages 13 to 64.
In South Africa, 1.2 million lives could be saved over the next five years if access to antiretroviral drugs is ramped up. Helped U.S. ambassador to South Africa assess priorities for HIV care in the country.
In South Africa, starting antiretroviral therapy earlier during the course of the disease would, over the next five years, avert 220,000 opportunistic infections and 250,000 deaths. Among the data used to motivate the World Health Organization to update its antiretroviral therapy guidelines to recommend that therapy start sooner.
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