Evaluating the Cost-Effectiveness of Scaling Long-Acting Injectable PrEP Among PWID: The Role of Uptake and Population Characteristics

Long-acting injectable pre-exposure prophylaxis (LAI-PrEP) shows promise in offering protection against HIV for people who use drugs, a population that accounts for 10% of new HIV cases.  While daily oral PrEP is highly effective at reducing the spread of HIV, studies show that PWID may have difficulty engaging in the PrEP care continuum. A recent survey reported less than 2% of PWID used PrEP in 2024. At the same time, LAI-PrEP costs more than the daily oral PrEP and may not be affordable  for all public health programs.

To understand the tradeoffs involved in scaling up the use of FDA-approved LAI-PrEP by PWID, this pilot project will leverage an existing simulation model to identify patterns that influence the effectiveness of PrEP for PWID and will conduct a cost-effectiveness analysis comparing LAI-PrEP and generic PrEP for PWID. Findings from this study will offer an expanded modeling framework to guide future health and economic evaluations of harm reduction, clinical, and social interventions for PWID, and provide critical evidence for tailoring HIV prevention strategies and resources for PWID.

Leaf Ye is a postdoctoral researcher in the Department of Health Policy at Stanford University, specializing in the development of decision-making simulation models to inform disease prevention programs. She has been evaluating the impact of HCV screening and treatment interventions within the California prison system, focusing on their effectiveness and broader public health implications. This work has strengthened her dedication to improving health outcomes among individuals who are incarcerated or have a history of incarceration, a group that faces higher rates of infection and often has limited access to medical care. Ye has also conducted research on cost-effectiveness thresholds, health outcomes, and health burden surveys.

Previously, Ye served as a lecturer at the School of Public Administration at Hainan University. She holds a PhD in pharmacy administration with a concentration in pharmacoeconomics from Shenyang Pharmaceutical University. Growing up in a low-income community, Ye witnessed firsthand how socioeconomic factors like income, education, and social circumstances profoundly shape health outcomes. These experiences continue to motivate her commitment to increasing healthcare access and advocating for improved health among frequently overlooked groups.