A review of the cost-effectiveness of interventions to prevent sexual transmission of HIV in the United States

Because resources to fund HIV prevention are limited, public health decision makers - such as health departments and HIV prevention community planning groups - need to know which prevention strategies are the most cost-effective. In the past several years, a number of studies have appeared in the literature that assess the cost-effectiveness of interventions to prevent the sexual transmission of HIV in the United States. Here, we comprehensively review 16 such studies and then outline an agenda for further research to advance the cost-effectiveness literature and to make the findings of these studies more useful for public health decision makers. The research summarized here provides compelling evidence that interventions to prevent sexual transmission of HIV can be highly cost-effective. Small-group, community-level, and outreach-based sexual risk reduction interventions, in particular, appear to be very efficient strategies for preventing the spread of HIV in moderate- to high-risk populations.