Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #116127

Kimberly Nichols Dauner, MPH¹, Donna L. Richter, EdD, FAAHB¹, Willie H. Oglesby, MSPH², Christopher M. LaRose, MA¹, and David Holtgrave, PhD³. (1) Arnold School of Public Health, University of South Carolina, Health Sciences Building, Columbia, SC 29208, (2) Office of Public Health Practice, University of South Carolina, Arnold School of Public Health, 800 Sumter Street, Room 109, Columbia, SC 29208, 803-777-6558, boglesby@sc.edu, (3) Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Room 540, Atlanta, GA 30322

Background: While the number of new HIV infections each year remains steady, funding for prevention has become more competitive. Prevention programs need to justify program costs in terms of evaluation outcomes. One such outcome is cost-effectiveness. Calculating the break-even point, or “threshold”, at which a program's costs outweigh its benefits is one way to measure this. This “threshold analysis” was used to evaluate the cost-effectiveness of a CDC-funded, national capacity-building program for community-based HIV prevention organizations. Methods: Standard methods of cost and threshold analysis were used to compare the costs of the program from both governmental and societal perspectives to the cost of lifetime treatment per case of HIV, yielding an estimate of the number of HIV infections that would have to be prevented for the program to be considered cost-effective. Results: The 136 persons who completed the capacity-building program between 2000 and 2003 would have had to avert 32 to 41 cases of HIV infection nationwide for the government and society's investments to be offset by the medical costs saved. Thus, each program participant would have had to avert less than one HIV infection each for the program to be considered cost-effective. Conclusions: These figures represent less than one-tenth of 1% of the 40,000 new HIV infections that occur in the U.S. each year and suggest a feasible performance standard for the program indicative of cost-effectiveness. These data underscore the substantial commitment of resources that are needed to prevent HIV.

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