Limits...
Allocating HIV prevention funds in the United States: recommendations from an optimization model.

Lasry A, Sansom SL, Hicks KA, Uzunangelov V - PLoS ONE (2012)

Bottom Line: Model results can be summarized into three main recommendations.Second, counseling and education interventions ought to provide a greater focus on HIV positive persons who are aware of their status.The main conclusions of the HIV resource allocation model have played a role in the introduction of new programs and provide valuable guidance to target resources and improve the impact of HIV prevention efforts in the United States.

View Article: PubMed Central - PubMed

Affiliation: Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America. alasry@cdc.gov

ABSTRACT
The Centers for Disease Control and Prevention (CDC) had an annual budget of approximately $327 million to fund health departments and community-based organizations for core HIV testing and prevention programs domestically between 2001 and 2006. Annual HIV incidence has been relatively stable since the year 2000 and was estimated at 48,600 cases in 2006 and 48,100 in 2009. Using estimates on HIV incidence, prevalence, prevention program costs and benefits, and current spending, we created an HIV resource allocation model that can generate a mathematically optimal allocation of the Division of HIV/AIDS Prevention's extramural budget for HIV testing, and counseling and education programs. The model's data inputs and methods were reviewed by subject matter experts internal and external to the CDC via an extensive validation process. The model projects the HIV epidemic for the United States under different allocation strategies under a fixed budget. Our objective is to support national HIV prevention planning efforts and inform the decision-making process for HIV resource allocation. Model results can be summarized into three main recommendations. First, more funds should be allocated to testing and these should further target men who have sex with men and injecting drug users. Second, counseling and education interventions ought to provide a greater focus on HIV positive persons who are aware of their status. And lastly, interventions should target those at high risk for transmitting or acquiring HIV, rather than lower-risk members of the general population. The main conclusions of the HIV resource allocation model have played a role in the introduction of new programs and provide valuable guidance to target resources and improve the impact of HIV prevention efforts in the United States.

Show MeSH
Model allocation to intervention types by budget amount.
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC3368881&req=5

pone-0037545-g002: Model allocation to intervention types by budget amount.

Mentions: We evaluate five budget scenarios where the total budget is set between $100 million and $500 million in increments of $100 million. Figure 2 displays the allocation to testing and counseling and education interventions for each budget scenario. At $100 million, the budget is allocated to testing only but as the budget increases, more funds are allocated to counseling and education interventions and at a budget of $500 million more funds are allocated to counseling and education interventions than to testing. Figure 3 presents the allocation by risk group. At $100 million, 84% of the budget is allocated to MSM and the remainder to IDUs; as the budget increases, more funds are allocated to all three risk groups. At a budget of $500 million the proportion of funds allocated to MSM, IDUs and HRH is 55%, 16% and 29% respectively. Table 3 presents new infections over the five-year horizon as the annual budget increases. The marginal infections averted decrease from 38,506 to 5,906 and represent the reduction in HIV incidence for each additional $100 million made available in the annual budget. The total number of infections averted relative to no investment is also presented in Table 3 along with the resulting cost per infection averted, medical costs averted and an estimate of the cost-savings incurred which are increasing from $13 billion to $23 billion. The medical costs are based on the lifetime treatment cost of an HIV infection estimated at $367,000 (US$ 2009) [32].


Allocating HIV prevention funds in the United States: recommendations from an optimization model.

Lasry A, Sansom SL, Hicks KA, Uzunangelov V - PLoS ONE (2012)

Model allocation to intervention types by budget amount.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3368881&req=5

pone-0037545-g002: Model allocation to intervention types by budget amount.
Mentions: We evaluate five budget scenarios where the total budget is set between $100 million and $500 million in increments of $100 million. Figure 2 displays the allocation to testing and counseling and education interventions for each budget scenario. At $100 million, the budget is allocated to testing only but as the budget increases, more funds are allocated to counseling and education interventions and at a budget of $500 million more funds are allocated to counseling and education interventions than to testing. Figure 3 presents the allocation by risk group. At $100 million, 84% of the budget is allocated to MSM and the remainder to IDUs; as the budget increases, more funds are allocated to all three risk groups. At a budget of $500 million the proportion of funds allocated to MSM, IDUs and HRH is 55%, 16% and 29% respectively. Table 3 presents new infections over the five-year horizon as the annual budget increases. The marginal infections averted decrease from 38,506 to 5,906 and represent the reduction in HIV incidence for each additional $100 million made available in the annual budget. The total number of infections averted relative to no investment is also presented in Table 3 along with the resulting cost per infection averted, medical costs averted and an estimate of the cost-savings incurred which are increasing from $13 billion to $23 billion. The medical costs are based on the lifetime treatment cost of an HIV infection estimated at $367,000 (US$ 2009) [32].

Bottom Line: Model results can be summarized into three main recommendations.Second, counseling and education interventions ought to provide a greater focus on HIV positive persons who are aware of their status.The main conclusions of the HIV resource allocation model have played a role in the introduction of new programs and provide valuable guidance to target resources and improve the impact of HIV prevention efforts in the United States.

View Article: PubMed Central - PubMed

Affiliation: Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America. alasry@cdc.gov

ABSTRACT
The Centers for Disease Control and Prevention (CDC) had an annual budget of approximately $327 million to fund health departments and community-based organizations for core HIV testing and prevention programs domestically between 2001 and 2006. Annual HIV incidence has been relatively stable since the year 2000 and was estimated at 48,600 cases in 2006 and 48,100 in 2009. Using estimates on HIV incidence, prevalence, prevention program costs and benefits, and current spending, we created an HIV resource allocation model that can generate a mathematically optimal allocation of the Division of HIV/AIDS Prevention's extramural budget for HIV testing, and counseling and education programs. The model's data inputs and methods were reviewed by subject matter experts internal and external to the CDC via an extensive validation process. The model projects the HIV epidemic for the United States under different allocation strategies under a fixed budget. Our objective is to support national HIV prevention planning efforts and inform the decision-making process for HIV resource allocation. Model results can be summarized into three main recommendations. First, more funds should be allocated to testing and these should further target men who have sex with men and injecting drug users. Second, counseling and education interventions ought to provide a greater focus on HIV positive persons who are aware of their status. And lastly, interventions should target those at high risk for transmitting or acquiring HIV, rather than lower-risk members of the general population. The main conclusions of the HIV resource allocation model have played a role in the introduction of new programs and provide valuable guidance to target resources and improve the impact of HIV prevention efforts in the United States.

Show MeSH