J G Kahn1, S M Kegeles, R Hays, N Beltzer. 1. Center for AIDS Prevention Studies (CAPS) and AIDS Research Institute (ARI), San Francisco, CA 94143, USA. jgkahn@itsa.ucsf.edu
Abstract
OBJECTIVES: Previous evaluation demonstrated that the Mpowerment Project community-level intervention for young gay men reduces HIV risk behaviors. The current analysis was undertaken to estimate the intervention's health and economic outcomes. DESIGN/ METHODS: We conducted a retrospective cost-effectiveness analysis. We estimated HIV infections averted, the gain in quality-adjusted life years (QALYs), cost per infection averted, and net cost. Using a population-level model, we portrayed two epidemic scenarios: the first with stable HIV prevalence and the other with rising HIV prevalence. Inputs included behavior change resulting from the intervention and program cost data. Cost was calculated from three perspectives: societal; societal excluding volunteer time; and that of a community-based organization (CBO). Outcomes were calculated for 1, 5 (baseline), and 20 years. RESULTS: The Mpowerment Project averted an estimated 2.0 to 2.3 HIV infections in the first year (according to the epidemic scenario), 5.0 to 6.2 over 5 years, and 9.2 to 13.1 over 20 years. The societal cost per HIV infection averted was estimated at between $14,600 and $18,300 over 5 years. Costs per infection averted were 28% lower when excluding volunteer time and 35% lower from the CBO perspective. Net savings were $700,000 to $900,000 over 5 years from the societal perspective. CONCLUSIONS: The Mpowerment Project is cost-effective compared with many other HIV prevention strategies. The cost per HIV infection prevented is far less than the lifetime medical costs of HIV disease.
OBJECTIVES: Previous evaluation demonstrated that the Mpowerment Project community-level intervention for young gay men reduces HIV risk behaviors. The current analysis was undertaken to estimate the intervention's health and economic outcomes. DESIGN/ METHODS: We conducted a retrospective cost-effectiveness analysis. We estimated HIV infections averted, the gain in quality-adjusted life years (QALYs), cost per infection averted, and net cost. Using a population-level model, we portrayed two epidemic scenarios: the first with stable HIV prevalence and the other with rising HIV prevalence. Inputs included behavior change resulting from the intervention and program cost data. Cost was calculated from three perspectives: societal; societal excluding volunteer time; and that of a community-based organization (CBO). Outcomes were calculated for 1, 5 (baseline), and 20 years. RESULTS: The Mpowerment Project averted an estimated 2.0 to 2.3 HIV infections in the first year (according to the epidemic scenario), 5.0 to 6.2 over 5 years, and 9.2 to 13.1 over 20 years. The societal cost per HIV infection averted was estimated at between $14,600 and $18,300 over 5 years. Costs per infection averted were 28% lower when excluding volunteer time and 35% lower from the CBO perspective. Net savings were $700,000 to $900,000 over 5 years from the societal perspective. CONCLUSIONS: The Mpowerment Project is cost-effective compared with many other HIV prevention strategies. The cost per HIV infection prevented is far less than the lifetime medical costs of HIV disease.
Authors: Dolores Albarracín; Jeffrey C Gillette; Allison N Earl; Laura R Glasman; Marta R Durantini; Moon-Ho Ho Journal: Psychol Bull Date: 2005-11 Impact factor: 17.737
Authors: Marta R Durantini; Dolores Albarracín; Amy L Mitchell; Allison N Earl; Jeffrey C Gillette Journal: Psychol Bull Date: 2006-03 Impact factor: 17.737
Authors: Gift Trapence; Chris Collins; Sam Avrett; Robert Carr; Hugo Sanchez; George Ayala; Daouda Diouf; Chris Beyrer; Stefan D Baral Journal: Lancet Date: 2012-07-20 Impact factor: 79.321
Authors: Verughese Jacob; Sajal K Chattopadhyay; Randy W Elder; Maren N Robinson; Kristin A Tansil; Robin E Soler; Magdala P Labre; Shawna L Mercer Journal: Am J Prev Med Date: 2014-09 Impact factor: 5.043