Integrated Interventions for Syndemics – Center for Health Decision Science

Integrated interventions can more efficiently address syndemics, which involve interacting epidemics driven by social and structural factors that can concentrate excess disease burden among marginalized populations. At a recent CHDS seminar, Marissa Reitsma presented ongoing research modeling the syndemic experienced by people who inject drugs. Reitsma is an Assistant Professor of Health Policy at Stanford University School of Medicine.

Traditional cost-effectiveness studies have largely focused on interventions that address health outcomes associated with individual conditions, but in practice, interventions can address multiple epidemics that interact through social and structural factors. Recent reports from US federal agencies have highlighted the need for integrated programs to address the syndemic of viral hepatitis, HIV, sexually transmitted infections, and substance use disorders. In response, Reitsma and colleagues developed an agent-based model of HIV and Hepatitis C virus transmission among people who inject drugs, parameterized using real-world data. They evaluated the health impacts of scaling interventions that reduce transmission probabilities, increase injection cessation, increase testing and treatment of infections, and/or reduce excess mortality due to drug use.

They are applying this to evaluate the effectiveness and cost-effectiveness of syringe service programs and integrated substance use disorder treatment programs in partnership with agencies at the state and local levels.

Learn more: Read the publication, Health Benefits, Costs, and Cost-Effectiveness of Jail-Based Hepatitis C Elimination Strategies
Learn more: Read the publication, Potential Impact of Frequent Testing for Hepatitis C Virus among People Who Inject Drugs Toward Hepatitis C Elimination in the United States
Learn more: Read the publication, Health and Economic Impact of Periodic Hepatitis C Virus Testing among People Who Inject Drugs