Cost-effectiveness of a community-level HIV risk reduction intervention for women living in low-income housing developments.


Journal Article

We conducted a cost-effectiveness analysis of a multi-site community-level HIV prevention trial that enrolled women living in 18 low-income housing developments in 5 U.S. cities. A mathematical model of HIV transmission was used to estimate the number of HIV infections averted and quality-adjusted life years (QALYs) saved by the community-level intervention, based on data obtained from community-wide sexual behavior surveys at baseline and 12-month follow-up. Results indicated that the intervention prevented approximately 1 infection per 3500 women reached by the intervention, at a total cost of 174,845 dollars. The cost per QALY saved by the intervention was 37,433 dollars and the cost per HIV infection averted was 732,072 dollars. The community-level intervention was moderately cost-effective in comparison with other HIV prevention programs for at-risk women. Synergistic approaches to HIV prevention that combine community-level sexual norm change interventions with more intensive risk reduction programs for high-risk women are needed. EDITORS' STRATEGIC IMPLICATIONS: The authors present a promising and efficient community-level HIV prevention approach, with effects beyond the limited scope of individual or small group interventions. This paper represents an example of how an analysis of cost-effectiveness can provide policymakers with information needed for difficult decisions about prevention resource allocations.

Full Text

Duke Authors

Cited Authors

  • Johnson-Masotti, AP; Pinkerton, SD; Sikkema, KJ; Kelly, JA; Wagstaff, DA

Published Date

  • July 2005

Published In

Volume / Issue

  • 26 / 4

Start / End Page

  • 345 - 362

PubMed ID

  • 15995803

Pubmed Central ID

  • 15995803

Electronic International Standard Serial Number (EISSN)

  • 1573-6547

International Standard Serial Number (ISSN)

  • 0278-095X

Digital Object Identifier (DOI)

  • 10.1007/s10935-005-5392-2


  • eng