Cost Effectiveness of HIV Prevention Interventions in the US
Cost Effectiveness of HIV Prevention Interventions in the US
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DOI：
10.1016/j.amepre.2016.01.011
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发表时间：
2016-06-01
影响因子：
5.5
通讯作者：
Sansom, Stephanie L.
中科院分区：
文献类型：
--
作者：
Lin, Feng;Farnham, Paul G.;Sansom, Stephanie L.
前言：本研究的目的是评估和比较美国目前艾滋病预防干预措施的成本效益，采用一致的标准化方法。方法：对男男性行为者、注射吸毒者和性活跃异性恋者提供的常见和新出现的艾滋病毒生物医学和行为预防干预措施的成本效益进行评估。有关项目成本、干预效果、风险行为和每次接触传播概率的数据收集自同行评议的论文和卫生部门的报告。这些数据与2010年全国艾滋病毒发病率和流行率监测数据结合在伯努利过程模型中，以估计与这些干预措施相关的艾滋病毒传播或感染的年度风险降低。然后计算每个预防艾滋病毒病例的成本和每个节省的质量调整生命年的成本。分析在2014年至2015年期间进行。结果：诊断艾滋病毒并提供持续护理和治疗的干预措施每预防病例的成本最低。在针对特定风险群体的干预措施中，针对男男性行为者的干预措施最具成本效益。成本效益最低的干预措施通常针对有感染艾滋病毒风险的人，而不是有传播疾病风险的人。结论：针对高危人群的艾滋病毒预防干预措施、与护理连续性相关的干预措施以及降低艾滋病毒感染者传播风险的干预措施通常是最具成本效益的。决策者在规划有效分配艾滋病毒预防资源时可以考虑这些结果。由爱思唯尔公司代表美国预防医学杂志出版
Introduction: The purpose of this study was to assess and compare the cost effectiveness of current HIV prevention interventions in the U.S. using a consistent, standardized methodology.Methods: The cost effectiveness of common and emerging HIV biomedical and behavioral prevention interventions as delivered to men who have sex with men, injection drug users, and sexually active heterosexuals was estimated. Data on program costs, intervention efficacy, risk behaviors, and per contact transmission probabilities were collected from peer-reviewed papers and health department reports. These data were combined with 2010 national HIV incidence and prevalence surveillance data in a Bernoulli process model to estimate the reduced annual risk of HIV transmission or acquisition associated with these interventions. The cost per prevented case of HIV and the cost per saved quality-adjusted life year were then calculated. Analyses were conducted between 2014 and 2015.Results: Interventions to diagnose HIV and provide ongoing care and treatment had the lowest cost per prevented case. Among interventions targeted at specific risk groups, interventions for men who have sex with men were the most cost effective. The least cost-effective interventions typically addressed people at risk of acquiring HIV rather than those at risk of transmitting the disease.Conclusions: HIV prevention interventions targeted at high-risk populations, those associated with the care continuum, and those that reduce the transmission risk of HIV-infected people are typically the most cost effective. Decision makers can consider these results in planning an efficient allocation of HIV prevention resources. Published by Elsevier Inc. on behalf of American Journal of Preventive Medicine