Cost effectiveness of Streetworks' needle exchange program of Edmonton.
OBJECTIVE
To conduct a cost-effectiveness analysis of the Edmonton Streetworks needle exchange program, in terms of the additional cost per HIV infection averted. The main outcome measures were needle use with and without Streetworks, HIV cases averted, and program costs.


METHODS
We conducted interviews and HIV saliva tests on a sample of street-involved intravenous drug users (IDU) who are regular Streetworks' clients. Outcomes were used in a cost-effectiveness model.


RESULTS
It is projected that the program has a cost-effectiveness of $9,500 (Canadian) per HIV infection delayed for one year.


CONCLUSIONS
The discounted cost per case averted is less than the cost of a case of AIDS. Continuing the program is a dominant strategy.
Department of Public Health Sciences, University of Alberta, Edmonton. Philip.Jacobs@ualberta.ca
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Jacobs
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Calder
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Taylor
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Houston
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Saunders
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Albert
D000328:Adult; D000416:Alberta / Q000453:epidemiology; D003362:Cost-Benefit Analysis; D005260:Female; D015658:HIV Infections / Q000191:economics* / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D015528:HIV Seroprevalence; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D018671:Needle-Exchange Programs / Q000191:economics* / Q000706:statistics & numerical data; D015397:Program Evaluation; D015819:Substance Abuse, Intravenous / Q000150:complications* / Q000523:psychology; D011795:Surveys and Questionnaires; D019037:Urban Health Services / Q000191:economics