COST EFFECTIVENESS OF DEVELOPING COUNTRY HIV PREVENTION

描述(申请人摘要)：目前对以下问题的共识有限 发展中国家预防HIV最有效的干预设计 国家。决定资助哪种类型的项目，应该由谁来资助 有针对性的干预措施，以及如何设计预防方案 是根据干预措施的成本效益比较得出的。一个 在这些问题上达成共识的主要问题是，现有的数据 而不是将成本与有效性衡量标准挂钩。成本和成本的标准化 在人群、地区和干预措施方面的结果也是 不可用。该项目将计算和比较标准化措施 预防艾滋病毒和艾滋病干预措施的成本效益 各种干预措施的性传播感染(STI)， 使用来自实际HIV/STI的数据的地理区域和目标人群 在非洲、拉丁美洲和亚洲的干预项目。性爱项目 所有被选中参加评估的人都与AIDSCAP项目有关，并得到资助 由美国国际开发署提供，包括：(1)a 多米尼加共和国的全面性工作者干预，(2)a 男男性行为者的同伴教育和咨询干预 多米尼加共和国，(3)性传播疾病和同伴教育干预 坦桑尼亚的工人，(4)农村的社区预防方案 坦桑尼亚，(5)泰国的工厂工人干预，和(6) 曼谷针对贫困妇女的全面艾滋病毒和性传播疾病干预措施， 泰国。全面和标准化的行为评估数据 适用于所有站点，并将在初始阶段收集成本数据 项目的各个阶段。类似未暴露的回溯性对照数据 还将对每个干预地点的人口进行汇编和分析。 避免了对每个艾滋病毒病例的折扣成本感兴趣的主要结果， 以及每次干预的每个质量调整生命年(QALY)的成本。 该项目还将有助于发展申请者的技能和经验 进行建模和健康经济分析。

DESCRIPTION (Applicant's Abstract): There is currently limited consensus on the most effective intervention designs for HIV prevention in developing countries. Decisions on which type of projects to fund, who should be targeted with interventions, and how to design prevention programs have not been based on comparisons of the cost-effectiveness of interventions. A major problem in forging consensus on these issues is that available data do not link costs to effectiveness measures. Standardization of costs and outcomes across populations, regions, and interventions has also been unavailable. This project will calculate and compare standardized measures of the cost-effectiveness of interventions for prevention of HIV and Sexually Transmitted Infections (STI) across types of interventions, geographic regions,and target populations using data from actual HIV/STI intervention projects in Africa, Latin America, and Asia. The sex projects selected for evaluation are all associated with the AIDSCAP project, funded by the US Agency of International Development, and include: (1) a comprehensive sex worker intervention in the Dominican Republic, (2) a peer-education and counseling intervention for men who have sex with men in the Dominican Republic, (3) a STD and peer-education intervention for sex workers in Tanzania, (4) a community-based prevention program in rural Tanzania, (5) a factory worker intervention in Thailand, and (6) a comprehensive HIV and STD intervention targeting poor women in Bangkok, Thailand. Comprehensive and standardized behavioral evaluation data are available for all sites, and cost data will be collected in the initial phase of the project. Retrospective control data on similarly unexposed populations will also be compiled and analyzed for each intervention site. The primary outcome of interest in the discounted cost per HIV case averted, and the cost per Quality Adjusted Life Year (QALY) for each intervention. This project will also help develop the applicant's skills and experience in conducting modeling and health economic analysis.