Modeling and Cost-Effectiveness in HIV Prevention.
Modeling and Cost-Effectiveness in HIV Prevention.
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DOI：
10.1007/s11904-016-0303-2
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发表时间：
2016-02
影响因子：
4.6
通讯作者：
Walensky RP
中科院分区：
文献类型：
--
作者：
Jacobsen MM;Walensky RP
随着艾滋病毒资助趋于稳定，以及由于推出挽救生命的抗逆转录病毒疗法而导致艾滋病毒感染者人数增加，政策制定者面临着日益紧张的预算来管理持续的艾滋病毒流行。成本效益和模型分析可以帮助确定哪些艾滋病毒干预措施可能具有最佳价值。在某些人群和国家，发病率仍然非常高，因此预防是控制艾滋病毒传播的关键。本文简要回顾了建模和成本效益方法中的概念，然后研究了最近发表的以下艾滋病毒预防策略的成本效益分析结果：安全套和包皮环切术、行为或社区干预措施、预防母婴传播、艾滋病毒检测、暴露前预防和治疗作为预防。我们发现大多数已发表的研究都证明了成本效益；然而，并非所有干预措施都是负担得起的。我们敦促继续研究考虑支付意愿和预算影响的组合战略和方法。
With HIV funding plateauing and the number of people living with HIV increasing due to the roll-out of life-saving antiretroviral therapy, policy makers are faced with increasingly tighter budgets to manage the ongoing HIV epidemic. Cost-effectiveness and modeling analyses can help determine which HIV interventions may be of best value. Incidence remains remarkably high in certain populations and countries, making prevention key to controlling the spread of HIV. This paper briefly reviews concepts in modeling and cost-effectiveness methodology, then examines results of recently published cost-effectiveness analyses on the following HIV prevention strategies: condoms and circumcision, behavioral or community-based interventions, prevention of mother to child transmission, HIV testing, pre-exposure prophylaxis, and treatment as prevention. We find that the majority of published studies demonstrate cost-effectiveness; however, not all interventions are affordable. We urge continued research on combination strategies and methodologies that take into account willingness to pay and budgetary impact.