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No Time to Lose Getting More from HIV Prevention (2001) / Chapter Skim
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Appendix D: Description and Mathematical Statement of the HIV Prevention Resource Allocation Model
Pages 173-179

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From page 173...
... The only description the Committee found of a systematic attempt to provide such estimates was a paper in the American Journal of Public Health (Holmberg, 1996~. Our analysis uses estimates of HIV incidence broken down by injection drug users, men who have sex with men, and high-risk heterosexuals for 96 Standard Metropolitan Statistical Areas in the United States, aggregated to the state level.
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From page 174...
... Yet, it is precisely this information about new infections that is required to sensibly consider the overall impact of alternative plans for distributing HIV prevention dollars. To develop data for this analysis, we reviewed in detail a subset of HIV prevention studies with an eye toward estimating the relative reduction in exposure to HIV risk as a result of prevention interventions aimed at men who have sex with men, injection drug users, and women at high risk for heterosexual transmission (see references at the end of this appendix for a listing of the studies reviewed)
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From page 175...
... Rather, the idea was to cover a wide range of possibilities with a very small number of scenarios. Some of the types of interventions used to construct the scenarios for the analysis include: individual risk reduction education, group counseling and skills training, community-level interventions in housing projects, identification and training of peer leaders to endorse and recommend safer-sex practices, counseling and HIV testing, partner notification, drug treatment, the provision of bleach for needle cleaning, needle exchange, and syringe access (e.g., via pharmacies)
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From page 176...
... Third, apply the percentage reductions in the rate of new infections to the appropriate HIV incidence base rate to obtain the annual number of new HIV infections averted per program participant: The number of HIV infections averted per program participant equals r ~ xe;.
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From page 177...
... Journal of Consulting and Clinical Psychology 66~5~:856-861. Carey MP, Maisto SA, Kalichman SC, Forsyth AD, Wright EM, Johnson BT.
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From page 178...
... AIDS 13~13~:1753-1762. Kelly JA, Murphy DA, Sikkema KJ, McAuliffe TL, Roffman RA, Solomon LJ, Winett RA, Kalichman SC.
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From page 179...
... New England Journal of Medicine 340~2~:93-100. Sikkema KJ, Kelly JA, Winett RA, Solomon LJ, Cargill VA, Roffman RA, McAuliffe TL, Heckman TG, Anderson EA, Wagstaff DA, Norman AD, Perry MJ, Crumble DA, Mercer MB.
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Key Terms

  • american journal
  • prevention programs
  • hiv incidence
  • hiv risk
  • economic evaluation

  • hiv infections
  • risk reduction
  • drug users
  • infections averted
  • injection drug

  • cost estimates
  • prevention budget
  • prevention intervention
  • optimal resource
  • immunodeficiency virus

  • effectiveness estimates
  • program participants
  • relative reduction
  • reduction intervention
  • human immunodeficiency

  • studies reviewed
  • prevention interventions
  • prevention studies
  • aggregate hiv
  • randomized trial

  • estimating aggregate
  • estimates combined
  • pessimistic scenario
  • minority women
  • optimistic scenario


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