Cost-utility analysis of behavioral interventions for HIV-infected persons to reduce HIV transmission in the USA

We developed an ordinary differential equation model to analyze the cost and utility (measured in quality adjusted life years, or QALYs) of three published behavioral HIV interventions that aim to reduce the risk of transmission from HIV-infected persons to their sexual partners. The ODE model maps measurements of behavioral risk reduction parameters, estimated from sampling, into costs and QALYs. Monte Carlo sampling was used to perform a probabilistic sensitivity analysis to quantify uncertainty in costs and QALYs due to parameter estimation error from sampling. The results suggested that the behavioral interventions considered in this study are most likely to be cost-saving, or at least cost-effective. Our study shows how statistical estimates of behavioral measures translates into uncertainty about health costs and outcomes and suggests implications for which data are important to collect when assessing cost-utility tradeoffs, and not just measures of risk reduction from behavioral interventions.