title: Cost-effectiveness of drug abuse treatment for primary prevention of acquired immunodeficiency syndrome: epidemiologic considerations.
abstract: The prevention of AIDS has justified recent increases in drug abuse treatment expenditures. Three of the epidemiologic considerations involved in assessing the cost-effectiveness of drug treatment for primary prevention of AIDS among IV drug users were discussed. First, the considerable geographic variation in the prevalence of the virus that causes AIDS suggests that areas with relatively low infection levels may be more cost-effective targets when allocating limited drug abuse treatment resources. Expansions and modifications in the current national HIV-1 serologic surveillance system will be needed to make informed resource allocation decisions. Second, when comparing the cost-effectiveness of two alternative treatment modalities or programs, the number of new HIV-1 infections does not appear to be an appropriate outcome measure. Serologic testing should be supplemented with self-reported drug use behaviors, with or without drug testing. Finally, significant opportunity costs may be associated with employing drug abuse treatment as the principal approach to primary prevention of HIV-1 infection among IVDUs, when alternative and complementary approaches are also effective. Specifically, treatment expansion is unlikely to be cost-effective when the demand for publicly funded treatment slots exceeds the number available and in communities where only a small minority of IVDUs are enrolled in treatment.
authors.affiliation: AIDS Outreach Intervention Project, University of Illinois, Chicago School of Public Health (M/C 922) 60612.
authors.forename: T M
authors.initials: TM
authors.lastname: Lampinen
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control*; D003362:Cost-Benefit Analysis; D004203:Disinfection; D015528:HIV Seroprevalence; D015276:Health Care Rationing; D006302:Health Services Research; D006801:Humans; D016485:Needle Sharing / Q000706:statistics & numerical data; D010353:Patient Education as Topic / Q000191:economics / Q000592:standards; D011322:Primary Prevention / Q000191:economics / Q000379:methods / Q000592:standards*; D012307:Risk Factors; D015819:Substance Abuse, Intravenous / Q000150:complications / Q000191:economics / Q000628:therapy*; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology