A Method for Evaluating the Economic Efficiency of HIV Behavioral Risk Reduction Interventions

To maximize the impact of public spending on HIV prevention, program managers, community planning groups, and other decision makers need accurate information on the economic efficiency (i.e., the relative balance between costs and consequences) of alternative HIV prevention strategies. This paper describes a technique for evaluating the economic efficiency of HIV behavioral risk reduction interventions within a cost–utility analytic framework. To determine the cost-effectiveness of the intervention, standardized values of the lifetime cost of treating HIV/AIDS and the number of quality-adjusted life years lost when someone becomes infected with HIV are combined with information about overall program costs and a model-based estimate of the number of infections averted by the intervention. The use of a standardized economic evaluation methodology for HIV prevention research, such as that proposed here, enhances cross-study comparability and thereby facilitates informed resource allocation decision making.