title: Economic Evaluation of Community-Based HIV Prevention Programs in Ontario: Evidence of Effectiveness in Reducing HIV Infections and Health Care Costs.
abstract: Investments in community-based HIV prevention programs in Ontario over the past two and a half decades are assumed to have had an impact on the HIV epidemic, but they have never been systematically evaluated. To help close this knowledge gap, we conducted a macro-level evaluation of investment in Ontario HIV prevention programs from the payer perspective. Our results showed that, from 1987 to 2011, province-wide community-based programs helped to avert a total of 16,672 HIV infections, saving Ontario's health care system approximately $6.5 billion Canadian dollars (range 4.8-7.5B). We also showed that these community-based HIV programs were cost-saving: from 2005 to 2011, every dollar invested in these programs saved about $5. This study is an important first step in understanding the impact of investing in community-based HIV prevention programs in Ontario and recognizing the impact that these programs have had in reducing HIV infections and health care costs.
authors.affiliation: The Ontario HIV Treatment Network, Toronto, Ontario, Canada.|Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Stephanie K Y
authors.initials: SK
authors.lastname: Choi
authors.affiliation: Department of Health, Behaviour and Society, Bloomberg School of Public Health, John Hopkins University, Baltimore, MD, USA.
authors.forename: David R
authors.initials: DR
authors.lastname: Holtgrave
authors.affiliation: The Ontario HIV Treatment Network, Toronto, Ontario, Canada.
authors.forename: Jean
authors.initials: J
authors.lastname: Bacon
authors.affiliation: The Ontario AIDS Network, Toronto, Ontario, Canada.
authors.forename: Rick
authors.initials: R
authors.lastname: Kennedy
authors.affiliation: AIDS Bureau, Ontario Ministry of Health and Long-term Care, Toronto, Ontario, Canada.
authors.forename: Joanne
authors.initials: J
authors.lastname: Lush
authors.affiliation: AIDS Bureau, Ontario Ministry of Health and Long-term Care, Toronto, Ontario, Canada.
authors.forename: Frank
authors.initials: F
authors.lastname: McGee
authors.affiliation: Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.|Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.|University Health Network, Toronto, Ontario, Canada.
authors.forename: George A
authors.initials: GA
authors.lastname: Tomlinson
authors.affiliation: The Ontario HIV Treatment Network, Toronto, Ontario, Canada. sean.rourke@utoronto.ca.|Li Ka Shing Knowledge Institute of St. Michael's Hospital, 30 Bond St., Toronto, Ontario, M5B 1W8, Canada. sean.rourke@utoronto.ca.|Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. sean.rourke@utoronto.ca.
authors.forename: Sean B
authors.initials: SB
authors.lastname: Rourke
mesh_terms: D055812:Community-Based Participatory Research; D003362:Cost-Benefit Analysis; D015658:HIV Infections / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control*; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D009864:Ontario / Q000453:epidemiology; D011314:Preventive Health Services / Q000191:economics*; D015397:Program Evaluation / Q000191:economics*
keywords: Community action; HIV; Macro-level analysis; Primary prevention; Program evaluation; Return on investment