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Cost-Effectiveness of a Community-Level HIV Risk Reduction Intervention for Women Living in Low-Income Housing Developments

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Abstract

We conducted a cost-effectiveness analysis of a multi-site community-level HIV prevention trial that enrolled women living in 18 low-income housing developments in 5 U.S. cities. A mathematical model of HIV transmission was used to estimate the number of HIV infections averted and quality-adjusted life years (QALYs) saved by the community-level intervention, based on data obtained from community-wide sexual behavior surveys at baseline and 12-month follow-up. Results indicated that the intervention prevented approximately 1 infection per 3500 women reached by the intervention, at a total cost of $174,845. The cost per QALY saved by the intervention was $37,433 and the cost per HIV infection averted was $732,072. The community-level intervention was moderately cost-effective in comparison with other HIV prevention programs for at-risk women. Synergistic approaches to HIV prevention that combine community-level sexual norm change interventions with more intensive risk reduction programs for high-risk women are needed.

Editors’ Strategic Implications:The authors present a promising and efficient community-level HIV prevention approach, with effects beyond the limited scope of individual or small group interventions. This paper represents an example of how an analysis of cost-effectiveness can provide policymakers with information needed for difficult decisions about prevention resource allocations.

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Authors and Affiliations

  1. Medical College of Wisconsin, U.S.A.

    Ana P. Johnson-Masotti Ph.D (Assistant Professor & Associate Chair), Steven D. Pinkerton & Jeffrey A. Kelly

  2. McMaster University, U.S.A.

    Ana P. Johnson-Masotti Ph.D (Assistant Professor & Associate Chair)

  3. Yale School of Medicine, U.S.A.

    Kathleen J. Sikkema

  4. Pennsylvania State University, U.S.A.

    David A. Wagstaff

  5. Department of Clinical Epidemiology and Biostatistics, McMaster University, Program for Assessment of Technology in Health (PATH), 25 Main Street West, Suite 2000, Hamilton, ON L8P 1H1

    Ana P. Johnson-Masotti Ph.D (Assistant Professor & Associate Chair)

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  1. Ana P. Johnson-Masotti Ph.D
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  2. Steven D. Pinkerton
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  3. Kathleen J. Sikkema
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Correspondence to Ana P. Johnson-Masotti Ph.D.

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Johnson-Masotti, A.P., Pinkerton, S.D., Sikkema, K.J. et al. Cost-Effectiveness of a Community-Level HIV Risk Reduction Intervention for Women Living in Low-Income Housing Developments. J Primary Prevent 26, 345–362 (2005). https://doi.org/10.1007/s10935-005-5392-2

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