COST UTILITY OF HIV PREVENTION IN THE NIMH TRIAL

职位描述(申请人摘要)：政策制定者、项目经理、 社区规划小组成员和其他关键决策者需要 在规划时平衡各种干预措施的成本和有效性 以及评估艾滋病毒预防计划。为预防艾滋病毒提供资金的资源 程序是有限的，必须明智地使用，以便最大化 避免了艾滋病毒感染的数量。艾滋病毒的经济评价研究 预防干预可以提供一些关键的所需信息 决策者。不幸的是，目前很少有这样的信息 但很少有正在进行的行为研究有经济评估 组件。NIMH资助了一项大型、多地点、随机对照试验 为了比较七个疗程、认知行为、艾滋病毒预防 干预以一次会议、教育、艾滋病毒预防干预为主。 在七个研究地点中的每个地点，都有三个群体得到服务 参加试验的对象：在初级卫生保健机构就诊的妇女； 到性病诊所就诊的女性和到性病诊所就诊的男性。没有研究 参赛者年龄不满18岁。12个月的随访 审判期限即将结束。主要成果衡量标准包括： 在过去90天内的性伴数量、阴道行为和 与每一位伴侣进行肛交；以及在以下情况下的行为比例 使用了避孕套。还收集了注射毒品使用情况的自我报告。 一些关于非艾滋病毒性传播疾病的信息也是通过查阅图表和 尿检(某些人群在特定时间段)。调查人员 建议通过追溯成本效益来扩大这一试验范围 分析。治疗和控制干预措施的费用将是 使用已发布和未发布的文档进行回溯估计 关于干预措施的交付。将映射行为结果数据 纳入健康结果(例如，估计避免感染艾滋病毒的人数) 使用数学建模技术。估计的成本和健康 对于每个特定人群，每个干预措施的结果将是 结合使用标准的成本-效用分析方法(CUA)。CUAS 包含对每种质量的干预成本的估计 已保存调整寿命年(QALY)。在这种情况下，CUA将是递增的。 也就是说，它将比较治疗干预的额外成本 (相对于控制干预)到由 治疗干预(相对于对照干预)。建议数 研究计划将包括发表成本-效用分析 成果发表在科学期刊上，并将包括一项专门的传播 为结果做计划。

DESCRIPTION (Applicant's Abstract): Policy makers, program managers, community planning group members and other key decision makers need to balance the cost and effectiveness of various interventions when planning and evaluating HIV prevention programs. Resources to fund HIV prevention programs are limited and must be used judiciously in order to maximize the number of HIV infections averted. Economic evaluation studies of HIV prevention interventions can provide some of the information needed by key decision makers. Unfortunately, little such information is currently available, and few ongoing behavioral studies have an economic evaluation component. NIMH has funded a major, multi-site, randomized controlled trial to compare a seven-session, cognitive-behavioral, HIV prevention intervention to a one-session, educational, HIV prevention intervention. Within each of the seven study sites, three populations are served and enrolled in the trial: women attending primary health care facilities; women attending STD clinics; and men attending STD clinics. No study participant is less than eighteen years of age. The 12 month follow-up period for the trial will soon be ending. Major outcomes measures include: numbers of sex partners in the past 90 days, number of acts of vaginal and anal intercourse with each partner; and proportion of acts during which condoms were used. Self-report of injection drug use were also collected. Some information about non-HIV STDs was also collected via chart review and urinalysis (for some populations at certain time periods.) The investigators propose to augment this trail with a retrospective cost-effectiveness analysis. The cost of the treatment and control interventions will be estimated retrospectively using published and unpublished documentation about intervention delivery. The behavioral outcome data will be mapped into health outcomes (e.g., estimated number of HIV infections averted) using mathematical modeling techniques. The estimated cost and health outcomes for each intervention, for each specific population, will be combined using standard methods of cost-utility analysis (CUA). CUAs contain estimates of how much the intervention cost for each quality adjusted life year (QALY) saved. In this case the CUA will be incremental. That is, it will compare the additional cost of the treatment intervention (relative to the control intervention) to the additional QALYs saved by the treatment intervention (relative to the control intervention). The proposed research program will include publication of the cost-utility analysis results in scientific journals, and will include a special dissemination plan for results.