title: A systematic review on cost effectiveness of HIV prevention interventions in the United States.
abstract: BACKGROUND
  The Centers for Disease Control and Prevention (CDC) focus on funding HIV prevention interventions likely to have high impact on the HIV epidemic. In its most recent funding announcement to state and local health department grantees, CDC required that health departments allocate the majority of funds to four HIV prevention interventions: HIV testing, prevention with HIV-positives and their partners, condom distribution and policy initiatives.
  
  
  OBJECTIVE
  We conducted a systematic review of the published literature to determine the extent of the cost-effectiveness evidence for each of those interventions.
  
  
  METHODS
  We searched for US-based studies published through October 2012. The studies that qualified for inclusion contained original analyses that reported costs per quality-adjusted life-year saved, life-year saved, HIV infection averted, or new HIV diagnosis. For each study, paired reviewers performed a detailed review and data extraction. We reported the number of studies related to each intervention and summarized key cost-effectiveness findings according to intervention type. Costs were converted to 2011 US dollars.
  
  
  RESULTS
  Of the 50 articles that met the inclusion criteria, 33 related to HIV testing, 15 assessed prevention with HIV-positives and partners, three reported on condom distribution, and one reported on policy initiatives. Methodologies and cost-effectiveness metrics varied across studies and interventions, making them difficult to compare.
  
  
  CONCLUSIONS
  Our review provides an updated summary of the published evidence of cost effectiveness of four key HIV prevention interventions recommended by CDC. With the exception of testing-related interventions, including partner services, where economic evaluations suggest that testing often can be cost effective, more cost-effectiveness research is needed to help guide the most efficient use of HIV prevention funds.
authors.affiliation: Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd. NE, Mailstop E-48, Atlanta, GA, 30329, USA, yhuang@cdc.gov.
authors.forename: Ya-Lin A
authors.initials: YL
authors.lastname: Huang
authors.forename: Arielle
authors.initials: A
authors.lastname: Lasry
authors.forename: Angela B
authors.initials: AB
authors.lastname: Hutchinson
authors.forename: Stephanie L
authors.initials: SL
authors.lastname: Sansom
mesh_terms: D002487:Centers for Disease Control and Prevention, U.S.; D003362:Cost-Benefit Analysis; D015658:HIV Infections / Q000191:economics* / Q000517:prevention & control*; D006801:Humans; D011322:Primary Prevention / Q000191:economics*; D019057:Quality-Adjusted Life Years; D055502:Secondary Prevention / Q000191:economics*; D014481:United States / Q000453:epidemiology