Anne Neilan, MD, MPH

HIV still poses significant challenges for young people in the United States, particularly those aged 13-24 living with HIV, many of whom grapple with adherence to antiretroviral therapy (ART) and engagement in care.

A study, led by Anne Neilan, MD, MPH, from the Division of Infectious Diseases in the Mass General Brigham Department of Medicine, aimed to explore the long-term healthcare costs specifically incurred by youth diagnosed and living with HIV.

This research utilized the CEPAC-Adolescent microsimulation model, a computer-based tool that uses data from various clinical studies to create a virtual population of adolescents living with HIV, allowing researchers to simulate their health outcomes, treatment adherence, and healthcare costs over time.

This study found that youth with HIV would incur an average lifetime cost of approximately $685,000 per person, totaling nearly $17 billion for an estimated population of 24,626. Antiretroviral therapy accounts for 74% of these costs, with the greatest expenses occurring during periods of low CD4 counts.

The study emphasizes the significant impact of ART pricing on overall costs, suggesting that generic pricing could reduce expenses by up to 62%.

It also highlights the challenges that youth face in adhering to treatment, which exacerbates costs and health outcomes. Interventions to enhance ART accessibility and reduce prices are crucial for improving care outcomes and managing costs effectively.

Published in BMC Health Services Research on December 05, 2025| Read the paper: “Projecting lifetime HIV-related healthcare costs for youth with HIV in the United States” 

Summary reviewed by: Anne Neilan, MD, MPH, lead author