Aquarius Population Health

Sexual Health & HIV

Improving clinical decision making and patient management

The Aquarius team has a breadth of experience in sexual health research and our work in this area has informed international policy and patient care. Projects within this field include health economic evaluations, assessing the impact of new innovations such as rapid diagnostics, measuring the burden of disease, evaluating alternative screening strategies and creating interactive tools to inform decisions making around adoption of new technologies.

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Case Studies

Cervical screening and HPV testing: Opportunities for rapid tests

We explored the use of a rapid, on-demand human papillomavirus (HPV) test. Interviews with UK experts revealed that a co-located, on-demand HPV test following cytology could reduce the time to cervical screening results by up to a week, with a near-patient primary HPV test followed by cytology triage could radically change the testing paradigm. A follow-up tool we built in Excel was used to understand cervical screening burden and HPV testing across Europe.

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The cost of pelvic inflammatory disease and potential cost-savings of chlamydia screening

We worked with clinicians from St Georges University who had published a trial estimating the incidence of pelvic inflammatory disease (PID) among women screened and unscreened for chlamydia. Patient data was analysed, and the average cost of managing PID was estimated to be £163 in community and hospital settings, and that over £60,000 could be saved in London alone from screening for chlamydia. This paper has been cited widely and results have informed policy and further modelling studies.

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Estimating the true costs of splitting HIV antiretroviral drugs

There is a temptation to switch to cheaper generic antiretroviral drugs compared to fixed-dose combination therapy for HIV patients in the interests of cost savings. However, in our analysis we found that there were no costs saved when including all patient care including drugs, additional clinic visits and monitoring. We also found that switching may cause confusion for some patients, risking loss of adherence. This evidence can help commissioners make better policy decisions about drug provision.

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Increased efficiency and improved treatment for stable HIV patients in England

Collaborators at St Georges Hospital wanted to understand the impact of changing service provision for stable HIV patients, as no evidence existed on what was best for clinics. We built a tool in Excel, and results indicated that 6-monthly appointments and 3-monthly home delivery of drugs is the cheapest option and could yield £2000 savings per patient, translating to an annual cost reduction of ~£8 million for the estimated 4000 eligible patients not currently on home delivery in England in 2012.

Continue Reading–>

Case Studies

Cervical screening and HPV testing: Opportunities for rapid tests

We explored the use of a rapid, on-demand human papillomavirus (HPV) test. Interviews with UK experts revealed that a co-located, on-demand HPV test following cytology could reduce the time to cervical screening results by up to a week, with a near-patient primary HPV test followed by cytology triage could radically change the testing paradigm. A follow-up tool we built in Excel was used to understand cervical screening burden and HPV testing across Europe.

Continue Reading–>

The cost of pelvic inflammatory disease and potential cost-savings of chlamydia screening

We worked with clinicians from St Georges University who had published a trial estimating the incidence of pelvic inflammatory disease (PID) among women screened and unscreened for chlamydia. Patient data was analysed, and the average cost of managing PID was estimated to be £163 in community and hospital settings, and that over £60,000 could be saved in London alone from screening for chlamydia. This paper has been cited widely and results have informed policy and further modelling studies.

Continue Reading–>

Estimating the true costs of splitting HIV antiretroviral drugs

There is a temptation to switch to cheaper generic antiretroviral drugs compared to fixed-dose combination therapy for HIV patients in the interests of cost savings. However, in our analysis we found that there were no costs saved when including all patient care including drugs, additional clinic visits and monitoring. We also found that switching may cause confusion for some patients, risking loss of adherence. This evidence can help commissioners make better policy decisions about drug provision.

Continue Reading–>

Increased efficiency and improved treatment for stable HIV patients in England

Collaborators at St Georges Hospital wanted to understand the impact of changing service provision for stable HIV patients, as no evidence existed on what was best for clinics. We built a tool in Excel, and results indicated that 6-monthly appointments and 3-monthly home delivery of drugs is the cheapest option and could yield £2000 savings per patient, translating to an annual cost reduction of ~£8 million for the estimated 4000 eligible patients not currently on home delivery in England in 2012.

Continue Reading–>

Publications

Publication of our economic evaluation comparing two cervical screening strategies in Belgium: HPV primary versus co-testing

Publication

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User experience and workflow performance: a pilot evaluation of the Genius Digital Diagnostics System for screening cervical cytology samples

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Evaluating the benefits and costs of using an mRNA versus DNA HR-HPV assay in the National Cervical Screening Programme in the Netherlands

Publication

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Modelling the impact of using a DNA compared to mRNA HPV assay as part of the cervical screening programmes in Sweden and Denmark

Publication

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Evaluating the choice of HPV assay in the French cervical screening programme with a decision tree model

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A cost effectiveness analysis of repeat screening for syphilis in pregnancy as an alternative screening strategy in the UK

Publication

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Examining the acceptability of offering STI screening in higher educational settings

Publication

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Modelling the choice of high-risk human papillomavirus (HR-HPV) assay in the English cervical screening programme

Publication

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Rapid testing and treatment for sexually transmitted infections improve patient care and yield public health benefits

Publication

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Cost-effectiveness of antimicrobial resistance point-of-care testing for optimising gonorrhoea treatment

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Evaluating multi-bug point-of-care tests for sexually transmitted infections

Evaluating the costs, benefits and cost-effectiveness of multi-pathogen point-of-care tests for sexually transmitted infections

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Modelling how point-of-care tests can enable personalised treatment for resistant gonorrhoea infections

Publication

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How can European countries improve cervical cancer prevention for women?

presentation_icon

Read Summary →

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Exploring the value of a rapid, on-demand test for the detection of human papillomavirus

presentation_icon

Read Summary →

Read Publication

Benefits of a point of care test for sexual health testing

publication_icon

Read Summary →

Read Publication

Managing Mycoplasma genitalium as an STI

publication_icon

Read Summary →

Read Publication

The financial and service implications of splitting fixed-dose antiretroviral drugs – a case study

publication_icon

Read Summary →

Read Publication

Point-of-care testing leads the way: article in the Parliamentary Review 2014

publication_icon

Read Summary →

Read Publication

Mapping patient pathways and cost of point of care versus standard testing and treatment for chlamydia and gonorrhoea in sexual health clinics

Read Journal Article

Read Summary →

Read Publication

Treatment for stable HIV patients in England: can we save costs and improve patient care?

publication_icon

Read Summary →

Read Publication

The cost-effectiveness of point of care tests for chlamydia and gonorrhoeae in sexual health clinics

publication_icon

Read Summary →

Read Publication

Cost effectiveness of screening for Chlamydia trachomatis in Ireland

Journal Article

Read Summary →

Read Publication

Costs and cost-effectiveness of different strategies for chlamydia screening and partner notification

publication_icon

Read Summary →

Read Publication

What is the cost of pelvic inflammatory disease and how much could be prevented by screening for chlamydia?

publication_icon

Read Summary →

Read Publication

Publications

Publication of our economic evaluation comparing two cervical screening strategies in Belgium: HPV primary versus co-testing

Publication

Read Summary →

Read Publication

User experience and workflow performance: a pilot evaluation of the Genius Digital Diagnostics System for screening cervical cytology samples

Publication

Read Summary →

Read Publication

Evaluating the benefits and costs of using an mRNA versus DNA HR-HPV assay in the National Cervical Screening Programme in the Netherlands

Publication

Read Summary →

Read Publication

Modelling the impact of using a DNA compared to mRNA HPV assay as part of the cervical screening programmes in Sweden and Denmark

Publication

Read Summary →

Read Publication

Evaluating the choice of HPV assay in the French cervical screening programme with a decision tree model

Publication

Read Summary →

Read Publication

A cost effectiveness analysis of repeat screening for syphilis in pregnancy as an alternative screening strategy in the UK

Publication

Read Summary →

Read Publication

Examining the acceptability of offering STI screening in higher educational settings

Publication

Read Summary →

Read Publication

Modelling the choice of high-risk human papillomavirus (HR-HPV) assay in the English cervical screening programme

Publication

Read Summary →

Read Publication

Rapid testing and treatment for sexually transmitted infections improve patient care and yield public health benefits

Publication

Read Summary →

Read Publication

Cost-effectiveness of antimicrobial resistance point-of-care testing for optimising gonorrhoea treatment

presentation_icon

Read Summary →

Read Presentation

Evaluating multi-bug point-of-care tests for sexually transmitted infections

Evaluating the costs, benefits and cost-effectiveness of multi-pathogen point-of-care tests for sexually transmitted infections

presentation_icon

Read Summary →

Read Publication

Modelling how point-of-care tests can enable personalised treatment for resistant gonorrhoea infections

Publication

Read Summary →

Read Publication

How can European countries improve cervical cancer prevention for women?

presentation_icon

Read Summary →

Read Publication

Exploring the value of a rapid, on-demand test for the detection of human papillomavirus

presentation_icon

Read Summary →

Read Publication

Benefits of a point of care test for sexual health testing

publication_icon

Read Summary →

Read Publication

Managing Mycoplasma genitalium as an STI

publication_icon

Read Summary →

Read Publication

The financial and service implications of splitting fixed-dose antiretroviral drugs – a case study

publication_icon

Read Summary →

Read Publication

Point-of-care testing leads the way: article in the Parliamentary Review 2014

publication_icon

Read Summary →

Read Publication

Mapping patient pathways and cost of point of care versus standard testing and treatment for chlamydia and gonorrhoea in sexual health clinics

Read Journal Article

Read Summary →

Read Publication

Treatment for stable HIV patients in England: can we save costs and improve patient care?

publication_icon

Read Summary →

Read Publication

The cost-effectiveness of point of care tests for chlamydia and gonorrhoeae in sexual health clinics

publication_icon

Read Summary →

Read Publication

Cost effectiveness of screening for Chlamydia trachomatis in Ireland

Journal Article

Read Summary →

Read Publication

Costs and cost-effectiveness of different strategies for chlamydia screening and partner notification

publication_icon

Read Summary →

Read Publication

What is the cost of pelvic inflammatory disease and how much could be prevented by screening for chlamydia?

publication_icon

Read Summary →

Read Publication

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