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Economic evaluation of HIV prevention programs

D R Holtgrave1, N L Qualls, J D Graham

  • 1Center for AIDS Intervention Research, Medical College of Wisconsin, Milwaukee 53202, USA.

Annual Review of Public Health
|January 1, 1996
PubMed
Summary
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Economic evaluations show that HIV prevention programs, particularly behavior change interventions, are cost-effective. More research is needed for unstudied intervention types and key populations to maximize averted HIV infections.

Area of Science:

  • Public Health
  • Health Economics
  • Behavioral Science

Background:

  • Limited resources necessitate judicious allocation for HIV prevention programs.
  • Program managers and policymakers require economic data to balance intervention costs and benefits.
  • Economic evaluation studies are crucial for maximizing averted HIV infections.

Purpose of the Study:

  • To review and critique economic evaluation studies of HIV prevention interventions.
  • To identify the cost-effectiveness of interventions, with a focus on behavior change.
  • To highlight research gaps in unstudied intervention types and key populations.

Main Methods:

  • Systematic review and critique of cost-benefit, cost-effectiveness, and cost-utility analyses.
  • Identification of 93 relevant economic evaluation studies.

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  • Categorization of studies based on intervention type (behavior change, screening/testing, care/treatment).

    • Main Results:

    • Ninety-three economic evaluation studies were identified.
    • Only 28 studies focused on domestic behavior change interventions.
    • Behavioral interventions are demonstrated to be cost-effective and potentially cost-saving.
    • Threshold conditions for cost-effectiveness are well-defined for behavioral interventions.

    Conclusions:

    • Behavioral interventions for HIV prevention are compellingly cost-effective and can be cost-saving.
    • Significant research gaps exist for certain intervention types and key populations.
    • Urgent research is needed in unstudied areas to optimize HIV prevention resource allocation.