Estimating the cost of unmet HIV-prevention needs in the United States

David R Holtgrave, Steven D. Pinkerton, Michael Merson

Research output: Contribution to journalArticle

Abstract

Background: Although new HIV infection cases have dropped from over 160,000 per year in the mid-1980s to 40,000 per year in the 1990s, HIV incidence has been relatively unchanged for a decade. This number of annual incident infections suggests that substantial, unmet HIV-prevention needs continue to fuel the HIV epidemic in the United States. Objectives: This study estimates the cost of addressing the unmet HIV-prevention needs in the United States and establishes a performance standard by estimating the number of HIV infections that would have to be prevented in order for these programs to be considered cost saving to society. Methods: Standard methods of cost and threshold analysis were employed in this study. Interventions needed to address unmet behavioral risks include services to reduce sexual risk of HIV infection, services to provide access to sterile syringes for people who cannot stop injecting drugs, HIV counseling and testing, and intensive preventive services to help HIV-seropositive people avoid transmitting the virus to others. Results: If brief interventions are utilized to address sexual behavior risk, the total program cost (over and above current resource levels) is just over $817 million; and if more expensive multisession, small-group interventions are used, the costs increase to over $1.85 billion. However, even the higher-cost program has a threshold of only 12,000 infections that must be prevented in order for the program to be considered a cost saving to society. Conclusions: Addressing the remaining unmet HIV-preventive needs in the United States will require a substantial commitment of resources. However, even a greatly expanded HIV-preventive program in the United States could pay for itself through savings in averted medical care costs.

Original languageEnglish (US)
Pages (from-to)7-12
Number of pages6
JournalAmerican Journal of Preventive Medicine
Volume23
Issue number1
DOIs
StatePublished - 2002
Externally publishedYes

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HIV
Costs and Cost Analysis
HIV Infections
Preventive Health Services
Syringes
Infection
Sexual Behavior
Health Care Costs
Counseling
Viruses
Incidence
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Medicine(all)
  • Public Health, Environmental and Occupational Health

Cite this

Estimating the cost of unmet HIV-prevention needs in the United States. / Holtgrave, David R; Pinkerton, Steven D.; Merson, Michael.

In: American Journal of Preventive Medicine, Vol. 23, No. 1, 2002, p. 7-12.

Research output: Contribution to journalArticle

Holtgrave, David R ; Pinkerton, Steven D. ; Merson, Michael. / Estimating the cost of unmet HIV-prevention needs in the United States. In: American Journal of Preventive Medicine. 2002 ; Vol. 23, No. 1. pp. 7-12.
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