HIV prevention, cost-utility analysis, and race/ethnicity: methodological considerations and recommendations

In this methodological article, the author reviews 1) the disproportionate impact that HIV/AIDS is having on communities of color in the United States, 2) what is known about the cost-effectiveness of HIV prevention interventions for racial/ethnic minority communities (including the methods used in these studies), and 3) the relative lack of methodological guidance in the field for conducting economic evaluation studies specifically for communities of color. The author finds that race/ethnicity affects cost-utility analyses in several heretofore unrecognized ways. In this article, methodological techniques to address these concerns are proposed. In particular, the author recommends cost-utility analytic strategies that maximize comparability among studies and avoid the introduction of methodological discrimination.