Threshold analysis and programs for prevention of HIV infection

Area of Science:

• Public Health
• Health Economics

Background:

• Assessing the economic effectiveness of HIV prevention is complex due to challenges in measuring behavioral changes and health outcomes.
• Traditional economic evaluations face difficulties in establishing clear cost-benefit metrics for public health interventions like HIV prevention.

Purpose of the Study:

• To establish a monetary threshold for cost per HIV infection averted.
• To apply a cost-utility analytic framework to determine societal willingness to pay for HIV prevention.
• To analyze the Centers for Disease Control and Prevention's 1993 HIV prevention budget using this framework.

Main Methods:

• Employed threshold analysis to define a cost level society may deem unacceptable for HIV infections averted.
• Utilized a cost-utility analytic framework to calculate the monetary threshold.
• Conducted sensitivity analyses based on varying willingness-to-pay values per quality-adjusted life year gained.

Main Results:

• The calculated monetary threshold for cost per HIV infection averted was $417,000 in 1993 dollars.
• Sensitivity analyses revealed a range of $185,000 to $648,000, contingent on the societal value placed on quality-adjusted life years.

Conclusions:

• Economic evaluations of HIV prevention programs can use this threshold as a starting point.
• Interventions can be initially assessed as above or below this economic benchmark.
• Further data refinement can enhance these dichotomous evaluations for more nuanced economic assessments.