COST EFFECTIVENESS OF DEVELOPING COUNTRY HIV PREVENTION

描述（申请人的摘要）：目前关于以下方面存在有限的共识： 在发展中国家预防艾滋病毒最有效的干预措施 国家 决定资助哪种类型的项目， 有针对性的干预措施，以及如何设计预防方案， 这是基于干预措施的成本效益比较。 一 就这些问题达成共识的一个主要问题是， 不将成本与成效措施挂钩。 费用标准化和 人口、地区和干预措施的结果也是 不可用. 该项目将计算和比较标准化措施 预防艾滋病毒干预措施的成本效益， 各类干预措施中的性传播感染， 使用实际艾滋病毒/性传播感染数据的地理区域和目标人群 非洲、拉丁美洲和亚洲的干预项目。 性项目 被选中进行评估的所有人都与AIDSCAP项目有关， 美国国际开发署，包括：（1） 在多米尼加共和国对性工作者进行全面干预，（2）a 对男男性行为者的同伴教育和咨询干预， 多米尼加共和国，（3）性传播疾病和同龄人性教育干预措施 坦桑尼亚的工人，（4）农村社区预防计划， 坦桑尼亚，（5）泰国的工厂工人干预，以及（6） 针对曼谷贫困妇女的艾滋病毒和性传播疾病综合干预， 泰国 全面、标准化的行为评估数据， 可用于所有研究中心，成本数据将在初始阶段收集 项目的阶段。 类似未暴露的回顾性对照数据 还将为每个干预地点汇编和分析人口。 主要结果是避免了对每个艾滋病毒病例的折扣成本的关注， 以及每项干预措施的质量调整生命年（QALY）成本。 该项目还将有助于发展申请人的技能和经验， 进行建模和卫生经济学分析。

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.