Health and economic impacts of an HIV intervention in out of treatment substance abusers: evidence from a dynamic model.
BACKGROUND
A community-based intervention program found that the high-risk target population interacts with its surrounding community as a source of drugs and prostitution, creating a measure of co-dependence in the health status of each group.


METHODS
The intervention collected extensive data on sexual and drug use practices in the target population. A dynamic compartment model estimates the epidemiological impact of the intervention, which serves as the basis for the economic assessment comparing intervention costs and lifetime HIV treatment costs.


RESULTS
Approximately 2/3 of the new infections arise in the surrounding community. Intervention spillover benefits in the surrounding community are sufficient to make the intervention cost-saving in the first year--a savings of approximately 534,000 dollars.


CONCLUSIONS
Conducting the intervention results in health benefits and cost-savings not only for the risk group, but for the entire community in which it resides. Quantifying the spillovers is vital to policymakers attempting to allocate scarce public health resources.
Richter
Anke
A
Defense Resource Management Institute, Naval Postgraduate School, 1522 Cunningham Rd, Code 64Rt, Monterey, CA 93943, USA. arichter@nps.navy.mil
Loomis
Brett
B
D000293:Adolescent; D000328:Adult; D003153:Community Health Services; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000191:economics / Q000517:prevention & control* / Q000628:therapy; D017048:Health Care Costs; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D018803:Models, Economic; D009657:North Carolina; D015397:Program Evaluation; D019966:Substance-Related Disorders / Q000150:complications*