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The cost-effectiveness of HIV prevention targeting: How much more bang for the buck?

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  • Kahn, J.G.

Abstract

Background. Although the targeting of human immunodeficiency virus (HIV) prevention to high-risk populations has been widely discussed, its benefits have not been quantified. Methods. This analysis of cost-effectiveness combines an HIV epidemic model, target population scenarios, and data on the cost and impact of prevention. Results. The number of HIV infections averted in 5 years with $1 million in annual prevention spending ranges from 164 in high-risk populations to 0.4 in very-low-risk populations. Fortyfold to two-hundredfold differences in prevention costs could equalize HIV infections averted. Conclusions. Targeting appears to provide substantial benefit and should be considered in allocation decisions about prevention.

Suggested Citation

  • Kahn, J.G., 1996. "The cost-effectiveness of HIV prevention targeting: How much more bang for the buck?," American Journal of Public Health, American Public Health Association, vol. 86(12), pages 1709-1712.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.86.12.1709_3
    DOI: 10.2105/AJPH.86.12.1709
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    Cited by:

    1. Wilson, Amy R. & Kahn, James G. & Oren, Shmuel S., 2005. "Targeting interventions to high-risk populations: Benefits and costs," Socio-Economic Planning Sciences, Elsevier, vol. 39(4), pages 335-349, December.
    2. Robalino, David A. & Jenkins, Carol & El Maroufi, Karim, 2002. "Risks and macroeconomic impacts of HIV/AIDS in the Middle East and North Africa : why waiting to intervene can be costly," Policy Research Working Paper Series 2874, The World Bank.
    3. James G. Kahn & Margaret L. Brandeau & John Dunn-Mortimer, 1998. "OR Modeling and AIDS Policy: From Theory to Practice," Interfaces, INFORMS, vol. 28(3), pages 3-22, June.
    4. Brandeau, Margaret L. & Zaric, Gregory S. & Richter, Anke, 2003. "Resource allocation for control of infectious diseases in multiple independent populations: beyond cost-effectiveness analysis," Journal of Health Economics, Elsevier, vol. 22(4), pages 575-598, July.
    5. Edward H. Kaplan, 1999. "Implicit Valuation of a Blood-exclusion Decision," Medical Decision Making, , vol. 19(2), pages 207-213, April.
    6. Gregory S. Zaric, 2003. "The Impact of Ignoring Population Heterogeneity when Markov Models are Used in Cost-Effectiveness Analysis," Medical Decision Making, , vol. 23(5), pages 379-386, September.
    7. Gregory S. Zaric & Margaret L. Brandeau, 2001. "Optimal Investment in a Portfolio of HIV Prevention Programs," Medical Decision Making, , vol. 21(5), pages 391-408, October.
    8. Stephanie R. Earnshaw & Anke Richter & Stephen W. Sorensen & Thomas J. Hoerger & Katherine A. Hicks & Michael Engelgau & Ted Thompson & K. M. Venkat Narayan & David F. Williamson & Edward Gregg & Ping, 2002. "Optimal Allocation of Resources across Four Interventions for Type 2 Diabetes," Medical Decision Making, , vol. 22(1_suppl), pages 80-91, September.
    9. Lasry, Arielle & Zaric, Gregory S. & Carter, Michael W., 2007. "Multi-level resource allocation for HIV prevention: A model for developing countries," European Journal of Operational Research, Elsevier, vol. 180(2), pages 786-799, July.

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