AEGiS-APPJ: Accounting for Future Risk Behaviors in HIV-Prevention Effectiveness Models

Important note: Information in this article was accurate in 2003. The state of the art may have changed since the publication date.

Accounting for Future Risk Behaviors in HIV-Prevention Effectiveness Models

AIDS & Public Policy Journal 18, no. 1/2 (Spring/Summer 2003) 46-58
Steven D. Pinkerton and Harrell W. Chesson

Model-derived estimates of the number of infections averted by HIV-prevention interventions often are used in cost-effectiveness analyses and other evaluations of intervention effectiveness. In the cost-effectiveness framework, successful prevention efforts are associated with averted health losses and savings in HIV/AIDS-related medical care treatment costs. However, these savings are realized only if intervention participants do not subsequently become infected through continuing risk behavior. Therefore, it is important that these models take into account the future risk behaviors of intervention participants, in order to avoid counting "delayed" infections as "averted" infections. Here we extend previous research by providing an expanded mathematical framework for assessing the impact of future risk behaviors on model-based assessments of intervention effectiveness. We consider both "primary" infections (that is, infections among previously uninfected intervention participants) and "secondary" infections (that is, infections among the partners of already-infected intervention participants). Finally, we examine how the issue of delayed infections affects the estimated cost-effectiveness rather than just the effectiveness of HIV-prevention interventions.
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APPJ031801-04

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