The cost-effectiveness of HIV prevention targeting: how much more bang for the buck?
BACKGROUND
Although the targeting of human immunodeficiency virus (HIV) prevention to high-risk populations has been widely discussed, its benefits have not been quantified.


METHODS
This analysis of cost-effectiveness combines an HIV epidemic model, target population scenarios, and data on the cost and impact of prevention.


RESULTS
The number of HIV infections averted in 5 years with $1 million in annual prevention spending ranges from 164 in high-risk populations to 0.4 in very-low-risk populations. Fortyfold to two-hundredfold differences in prevention costs could equalize HIV infections averted.


CONCLUSIONS
Targeting appears to provide substantial benefit and should be considered in allocation decisions about prevention.
Kahn
J G
JG
Department of Epidemiology and Biostatistics, University of California, San Francisco, USA.
D003362:Cost-Benefit Analysis; D004812:Epidemiologic Methods; D015658:HIV Infections / Q000191:economics* / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D015994:Incidence; D015233:Models, Statistical; D015995:Prevalence; D014481:United States / Q000453:epidemiology