School-based HIV/STD prevention programs: do benefits justify costs?
OBJECTIVE
To evaluate the city of Houston HIV/STD prevention program in public high schools using the cost-utility-analysis approach.


METHODS
The study design was cross-sectional, comparing students who had undertaken the program with those who had not, and was based on a range of variables. Data on reported sexual behavior were used in a model for estimating the probability of HIV infection. The difference between the intervention and comparison group participants in the probability of infection was the basis for estimating program effects in terms of averted HIV infections. Program costs were obtained from the city of Houston Department of Health and Human Services (DHHS). Scenario-based cost-utility-ratios were computed based on costs and effects.


RESULTS
The program was cost-saving for female and cost-effective for male participants when ethnicity adjusted HIV prevalence was used with the assumption of best case scenario. It remained cost-effective for female but not for male participants in the base case scenario. Using the unadjusted HIV prevalence, the program was only cost-effective for female participants in the best case scenario.


CONCLUSIONS
The program achieved significant risk reduction in HIV infection, particularly among female participants, on a relatively low budget.
Ateka
Givans K
GK
Baylor College of Medicine Children's Foundation-Lesotho, Maseru, Lesotho. gkateka@bcm.tmc.edu
Lairson
David R
DR
D000293:Adolescent; D003362:Cost-Benefit Analysis; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control*; D017048:Health Care Costs; D006266:Health Education / Q000191:economics*; D006801:Humans; D008297:Male; D017059:Models, Econometric; D015995:Prevalence; D015397:Program Evaluation; D012572:School Health Services / Q000191:economics*; D012725:Sexual Behavior; D013781:Texas / Q000453:epidemiology; D055815:Young Adult