Title of article :
Cost-Effectiveness Analysis of HIV/AIDS Prevention among Intravenous Drug Users in Iran’s Drop-in Centers
Author/Authors :
Mirahmadizadeh, Alireza Department of Epidemiology - School of Health - Non-communicable Diseases Research Center - Shiraz University of Medical Sciences, Shiraz, Iran , Majdzadeh, Reza Iranian Institute for Reduction of High-Risk Behaviors, Tehran, Iran , Mohammad, Kazem School of Public Health - Tehran University of Medical Sciences, Tehran, Iran
Abstract :
Background: The goal of this study was to analyze the costeffectiveness
of harm reduction programs among Intravenous
Drug Users (IDUs) who referred to Drop-In Centers (DICs)
for prevention of Human Immunodeficiency Virus/Acquired
Immune Deficiency Syndrome (HIV/AIDS) infection.
Methods: To calculate the cost-effectiveness of HIV/AIDS
prevention, we used data from a cross-sectional study carried
out in 2009 in which we selected 13 DICs out of 45 active DICs
using systematic random sampling. Through interview, data
of all IDUs (1309) who had attended DICs were collected by
means of a questionnaire approved by 3 experts. Averted cases of
HIV infection were considered as the unit of effectiveness. The
cost was also calculated from the perspective of governmental
service provider and all costs were converted into US dollar
(USD). Sensitivity analysis was used to measure the effect of
some uncertain parameters in modeling the number of HIV cases
that have been averted; also, Incremental Cost-Effectiveness
Ratio (ICER) was estimated.
Results: Results showed that the DICs averted around 120.2 HIV
cases in one year (102.977 cases from drug injection, 11.45 cases
from homosexual and 5.77 cases from heterosexual ways). ICER
for each HIV infection averted was 13,248.5 USD. Sensitivity
analysis showed that providing harm reduction services in the
best and worst case scenarios could change the ICER from 13,055
to 13,954 USD for each HIV case averted, respectively.
Conclusion: Since the most common cause of transmission
and spread of HIV infection in Iran is drug injection via needle
shared by IDUs, DICs programs in Iran could be cost-effective.
The necessity of expanding and developing DICs and their harm
reduction programs performed locally and nationally in order to
protect this high-risk groups is inevitable.
Keywords :
Cost-effectiveness analysis , HIV/AIDS , IDUs
Journal title :
Astroparticle Physics