title: A linear programming model for allocating HIV prevention funds with state agencies: a pilot study.
abstract: Given the initiatives to improve resource allocation decisions for HIV prevention activities, a linear programming model was designed specifically for use by state and local decision-makers. A pilot study using information from the state of Florida was conducted and studied under a series of scenarios depicting the impact of common resource allocation constraints. Improvements over the past allocation strategy in the number of potential infections averted were observed in all scenarios with a maximal improvement of 73%. When allocating limited resources, policymakers must balance efficiency and equity. In this pilot study, the optimal allocation (i.e., most-efficient strategy) would not distribute resources in an equitable manner. Instead, only 12% of at-risk people would receive prevention funds. We find that less efficient strategies, where 58% fewer infections are averted, result in significantly more equitable allocations. This tool serves as a guide for allocating funds for prevention activities.
authors: RTI Health Solutions, RTI International, 3040 Cornwallis Road, Research Triangle Park, NC 27709, USA. searnshaw@rti.org
authors: Stephanie R
authors: SR
authors: Earnshaw
authors: Katherine
authors: K
authors: Hicks
authors: Anke
authors: A
authors: Richter
authors: Amanda
authors: A
authors: Honeycutt
mesh_terms: D003657:Decision Making; D017598:Efficiency, Organizational / Q000191:economics; D005260:Female; D005380:Financing, Government / Q000191:economics / Q000379:methods; D005431:Florida; D006077:Government Agencies / Q000191:economics; D015658:HIV Infections / Q000517:prevention & control* / Q000635:transmission; D015276:Health Care Rationing / Q000191:economics* / Q000379:methods*; D006291:Health Policy / Q000191:economics; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D018803:Models, Economic; D010865:Pilot Projects; D011382:Programming, Linear; D012307:Risk Factors; D015819:Substance Abuse, Intravenous
references: JAMA. 1998 Oct 7;280(13):1161-7
references: 9777816
references: AIDS. 2000 Jun 16;14(9):1257-68
references: 10894291
references: Math Biosci. 2001 May;171(1):33-58
references: 11325383
references: Am J Public Health. 2003 Jun;93(6):912-4
references: 12773352
references: J Acquir Immune Defic Syndr. 2001 Aug 15;27(5):482-91
references: 11511826
references: Med Decis Making. 1996 Apr-Jun;16(2):99-107
references: 8778541
references: Nature. 1988 Jun 9;333(6173):514-9
references: 3374601
references: J Acquir Immune Defic Syndr. 2001 Dec 15;28(5):487-94
references: 11744839
references: Med Decis Making. 2004 Mar-Apr;24(2):181-91
references: 15090104
references: Am J Public Health. 2000 Jul;90(7):1100-11
references: 10897189
references: J Health Econ. 2003 Jul;22(4):575-98
references: 12842316
references: Med Decis Making. 2001 Sep-Oct;21(5):391-408
references: 11575489
references: Int J STD AIDS. 2002 Jun;13(6):384-92
references: 12015012
references: AIDS Educ Prev. 1997 Jun;9(3 Suppl):105-18
references: 9241402
references: J Acquir Immune Defic Syndr. 1992;5(11):1116-8
references: 1403641
references: J Health Econ. 1996 Oct;15(5):641-53
references: 10164046
references: Soc Sci Med. 1997 May;44(9):1303-12
references: 9141163
references: Am J Public Health. 2002 Dec;92(12):1905-7
references: 12453805
references: Am J Public Health. 1996 Oct;86(10):1442-5
references: 8876516
references: Health Care Manag Sci. 2005 Feb;8(1):67-79
references: 15782514
references: Am J Public Health. 1998 Aug;88(8):1239-42
references: 9702159
references: Med Decis Making. 2007 Jan-Feb;27(1):71-81
references: 17237455
references: J Acquir Immune Defic Syndr Hum Retrovirol. 1998 Jan 1;17(1):83-90
references: 9436764
references: AIDS. 1997 Mar;11(3):347-57
references: 9147427
references: J Acquir Immune Defic Syndr. 2000 Oct 1;25(2):164-72
references: 11103047
references: Sex Transm Dis. 1997 Jan;24(1):11-7
references: 9018778
references: BMC Infect Dis. 2002 Oct 11;2:24
references: 12377102