title: Modeling and Cost-Effectiveness in HIV Prevention.
abstract: With HIV funding plateauing and the number of people living with HIV increasing due to the rollout of life-saving antiretroviral therapy, policy makers are faced with increasingly tighter budgets to manage the ongoing HIV epidemic. Cost-effectiveness and modeling analyses can help determine which HIV interventions may be of best value. Incidence remains remarkably high in certain populations and countries, making prevention key to controlling the spread of HIV. This paper briefly reviews concepts in modeling and cost-effectiveness methodology and then examines results of recently published cost-effectiveness analyses on the following HIV prevention strategies: condoms and circumcision, behavioral- or community-based interventions, prevention of mother-to-child transmission, HIV testing, pre-exposure prophylaxis, and treatment as prevention. We find that the majority of published studies demonstrate cost-effectiveness; however, not all interventions are affordable. We urge continued research on combination strategies and methodologies that take into account willingness to pay and budgetary impact.
authors.affiliation: Medical Practice Evaluation Center (RPW, MMJ), Divisions of Infectious Diseases and General Internal Medicine (RPW), Massachusetts General Hospital, 50 Staniford Street, 9th Floor, Boston, MA, 02114, USA.
authors.forename: Margo M
authors.initials: MM
authors.lastname: Jacobsen
authors.affiliation: Medical Practice Evaluation Center (RPW, MMJ), Divisions of Infectious Diseases and General Internal Medicine (RPW), Massachusetts General Hospital, 50 Staniford Street, 9th Floor, Boston, MA, 02114, USA. rwalensky@partners.org.|Division of Infectious Diseases, Brigham and Women's Hospital (RPW), Boston, MA, USA. rwalensky@partners.org.|Harvard University Center for AIDS Research (RPW), Harvard Medical School, Boston, MA, USA. rwalensky@partners.org.
authors.forename: Rochelle P
authors.initials: RP
authors.lastname: Walensky
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use; D002944:Circumcision, Male / Q000191:economics; D017280:Condoms / Q000191:economics; D003362:Cost-Benefit Analysis / Q000191:economics*; D015658:HIV Infections / Q000191:economics* / Q000517:prevention & control* / Q000821:virology; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008297:Male; D008403:Mass Screening / Q000191:economics*; D008962:Models, Theoretical; D065129:Pre-Exposure Prophylaxis / Q000191:economics* / Q000379:methods
chemical_list: D019380:Anti-HIV Agents
keywords: Cost-effectiveness; HIV; Modeling; Prevention; Review; Science of prevention
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