The value of contraception to prevent perinatal HIV transmission.
OBJECTIVE
The objective of this study was to highlight the value of preventing unintended pregnancies among HIV-infected women as a strategy to prevent perinatal HIV transmission.


OBJECTIVE
The goal of this study was to assess the cost-effectiveness of family planning programs to avert HIV-positive births with the current programmatic emphasis: prenatal care services that provide and promote nevirapine for prevention of mother-to-child transmission of HIV.


METHODS
Cost-effectiveness analyses were conducted from the health system perspective during 1 year with a hypothetical sub-Saharan African population. Expected program costs were combined with number of HIV-positive births averted for each strategy.


RESULTS
At the same level of expenditure, the contraceptive strategy averts 28.6% more HIV-positive births than nevirapine for prevention of mother-to-child transmission of HIV.


CONCLUSIONS
Increasing contraceptive use among nonusers of contraception who do not want to get pregnant is cost-effective and is an equally important strategy to prevent perinatal transmission as prenatal care programs that provide and promote nevirapine to HIV-infected mothers.
Reynolds
Heidi W
HW
Health Services Research Division , Family Health International, Research Triangle Park, North Carolina 27709, USA. hreynolds@fhi.org
Janowitz
Barbara
B
Homan
Rick
R
Johnson
Laura
L
D000293:Adolescent; D000328:Adult; D017954:Africa South of the Sahara / Q000453:epidemiology; D019380:Anti-HIV Agents / Q000191:economics / Q000627:therapeutic use; D003267:Contraception / Q000191:economics* / Q000706:statistics & numerical data*; D003362:Cost-Benefit Analysis; D005260:Female; D015658:HIV Infections / Q000517:prevention & control* / Q000635:transmission*; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008875:Middle Aged; D019829:Nevirapine / Q000191:economics / Q000627:therapeutic use; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000517:prevention & control*; D011295:Prenatal Care / Q000191:economics / Q000706:statistics & numerical data
D019380:Anti-HIV Agents; D019829:Nevirapine