Handbook of Economic Evaluation of HIV Prevention Programs

If resources for HIV prevention efforts were truly unlimited, then this book would be en tirely unnecessary. In a world with limitless support for HIV prevention activities, one would simply implement all effective (or potentially effective) programs without regard to expense. We would do everything useful to prevent the further spread of the virus that has already claimed hundreds of thousands of lives in the United States and millions of lives worldwide. Unfortunately, funding for HIV prevention programs is limited. Even though the amount of available funding may seem quite large (especially in the United States), it is still fixed and not sufficient to meet all needs for such programs. This was very well illustrated in the summer of 1997 when over 500 community-based organizations applied for a combined total of $18 million of HIV prevention funding from the U.S. Centers for Disease Control and Prevention (CDC). Less than one-fifth ofthese organizations received support via this funding mechanism. Hence, although $18 million may seem like a large amount of money at first blush, it is not enough to meet all of the prevention needs that could be addressed by these community-based organizations.

Contenu

1. An Overview of Economic Evaluation Methodologies and Selected Issues in Methods Standardization.- 2. The Bernoulli-Process Model of HIV Transmission: Applications and Implications.- 3. Assessing the Cost-Effectiveness of HIV Prevention Interventions: A Primer.- 4. Economic Evaluation of Primary HIV Prevention in Injection Drug Users.- 5. Economic Evaluation of HIV Counseling and Testing Programs: The Influence of Program Goals on Evaluation.- 6. Economic Evaluation of HIV Screening Interventions.- 7. Changing Public Policy to Prevent HIV Transmission: The Role of Structural and Environmental Interventions.- 8. The Cost-Effectiveness of Small Group and Community-Level Interventions.- 9. The Cost-Effectiveness of the Components of a Comprehensive HIV Prevention Program: A Road Map of the Literature.- 10. Resource Allocation and the Funding of HIV Prevention.- 11. Economic Evaluation and HIV Prevention Decision Making: The State Perspective.- 12. Adapting Cost Analytic Techniques to Local HIV Prevention Programs.- 13. Economic Evaluation and HIV Prevention Community Planning: A Policy Analyst's Perspective.- 14. Threshold Analysis of AIDS Outreach and Intervention.- 15. A Few Reflections on the Practicality of Economic Evaluation Methods and Conclusions.- Appendix A. A Method to Measure the Costs of Counseling for HIV Prevention: Robin D. Gorsky.- Overview of a Cost Analysis.- Steps of a Cost Analysis.- Determination of Counseling Costs.- Choosing the Time Period.- Counting the Clients Served.- Inventorying the Resources Required.- Calculating the Cost Per Unit of Resource and the Number of Units Used.- Calculating the Total and Expected Cost of the Intervention.- Discussion.- Suggested Readings.- References.- Appendix B. Updates of Cost of Illness and Quality of LifeEstimates for Use in Economic Evaluations of HIV Prevention Programs: David R. Holtgrave and Steven D. Pinkerton.- Methods.- Previous Estimates of Cost of Illness and Quality of Life.- Scenario Analysis.- Results.- Discussion.- References.- Appendix C. Cost-Effectiveness of a Community-Level HIV Risk Reduction Intervention: Steven D. Pinkerton, David R. Holtgrave, Wayne J. DiFranceisco, L. Yvonne Stevenson, and Jeffrey A. Kelly.- Description of Intervention.- Cost-Effectiveness.- Methods.- Retrospective Cost Estimation.- Mathematical Modeling.- Estimation of QALYs Saved.- Calculation of Cost-Effectiveness and Cost-Utility Ratios.- Threshold and Sensitivity Analyses.- Results.- Costs.- Infections Averted and QALYs Saved.- Cost-Effectiveness and Cost-Utility Ratios.- Threshold and Sensitivity Analyses.- Discussion.- References.- Appendix D. HIV Prevention and Cost-Effectiveness Resources on the World Wide Web: Mary E. Turk, Steven D. Pinkerton, David R. Holtgrave, and Heather Cecil.- General Interest HIV/AIDS Sites.- Sites with Prevention Resources and Information.- Sites for Economic, Population, and Health-Care Information and Data.- U.S. Government Sites for Information and Data (Not Listed Previously).- Other Sites of Interest.- Sites for Relevant Journals.