How can we calculate the “E” in “CEA”?

Abstract

Because full funding for HIV/AIDS prevention interventions is unlikely to occur in the near future, it is essential that the resources available are spent in the most effective way possible. This paper presents a matrix of effectiveness coefficients for HIV/AIDS-related prevention interventions that can be used as an integral part of the coordinated strategic planning process currently underway by the World Bank and UNAIDS, as the interventions in the matrix are harmonized with the interventions in that process. Coefficients for four types of sexual behavior change (condom use, partner reduction, sexually transmitted infection treatment-seeking behavior, age at first sex) across three different risk groups (high, medium, low) are presented, along with their interquartile ranges. Results indicate that: (1) impacts seem greater when an intervention includes interpersonal contact, rather than targeting a more general audience; (2) although significant impacts are observed in the columns measuring changing condom use, other impacts are lower, and sometimes are actually (measured) zero; and (3) additional studies have evaluations of the number of sexual partners and have found a greater impact than previous studies. Although progress has been made in increasing the number of evaluation studies that can be utilized in this impact matrix, particularly in the area of youth interventions, there are still empty cells in which no studies report impacts. Finally, it is important to note that issues such as quality differences and synergies between programmes could have an effect on the impacts calculated for a particular strategic plan.

HIV prevention cost-effectiveness: a systematic review

“…Models are a useful resource to estimate final outcomes when data are not available. However, modeling on untested assumptions can be a disservice for policy because it may raise false expectations of programs, as there are still many empty cells in the effectiveness matrices [96]; thus, many CEA studies can be highly speculative. More efforts should be made to compare models and develop international guidelines to provide readers with tools to evaluate the results and assumptions of a model.…”

Modelling the impact of HIV prevention and treatment for men who have sex with men on HIV epidemic trajectories in low- and middle-income countries

“…The impact matrix is based on an extensive literature search 47 and prepopulated in the Goals model of the Spectrum suite. It is not specific to any particular country.…”

Critical Choices In Financing The Response To The Global HIV/AIDS Pandemic

“…The estimates were first calculated in 2001 and have evolved to include forty-eight interventions across prevention (22), care and treatment (6), mitigation (5), program support (11), and international support (4). 4 Our AIDS 2031 estimates incorporated target population sizes, unit costs, and coverage through 2031, and they considered new interventions that may become available such as preexposure prophylaxis, microbicides, vaccines, or cures.…”

“…The AIDS 2031 Modeling Working Group estimated the impact of the different scenarios on new HIV infections for the twenty countries with the most new infections, plus two more countries for geographic representativeness (Brazil and Mexico). 6 These results were scaled up to regional and global levels. 7 n Costs.…”