PMCCPMCCPMCC

Search tips
Search criteria 

Advanced

 
Logo of hsresearchLink to Publisher's site
 
Health Serv Res. 2001 June; 36(2): 335–355.
PMCID: PMC1089227

The cost and cost-effectiveness of an enhanced intervention for people with substance abuse problems at risk for HIV.

Abstract

OBJECTIVE: To estimate the costs, effectiveness, and cost-effectiveness of prevention interventions for out-of-treatment substance abusers at risk for HIV. This is the first cost-effectiveness study of an AIDS intervention that focuses on drug use as an outcome. STUDY DESIGN: We examined data from the North Carolina Cooperative Agreement site (NC CoOp). All individuals in the study were given the revised NIDA standard intervention and randomly assigned to either a longer, more personalized enhanced intervention or no additional intervention. We estimated the cost of each intervention and, using simple means analysis and multiple regression models, estimated the incremental effectiveness of the enhanced intervention relative to the standard intervention. Finally, we computed cost-effectiveness ratios for several drug use outcomes and compared them to a "back-of-the-envelope" estimate of the benefit of reducing drug use. PRINCIPAL FINDINGS: The estimated cost of implementing the standard intervention is $187.52, and the additional cost of the enhanced intervention is $124.17. Cost-effectiveness ratios range from $35.68 to $139.52 per reduced day of drug use, which are less than an estimate of the benefit per reduced drug day. CONCLUSIONS: The additional cost of implementing the enhanced intervention is relatively small and compares favorably to a rough estimate of the benefits of reduced days of drug use. Thus, the enhanced intervention should be considered an important additional component of an AIDS prevention strategy for out-of-treatment substance abusers.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.9M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Booth RE, Crowley TJ, Zhang Y. Substance abuse treatment entry, retention and effectiveness: out-of-treatment opiate injection drug users. Drug Alcohol Depend. 1996 Sep;42(1):11–20. [PubMed]
  • Cottler LB, Leukefeld C, Hoffman J, Desmond D, Wechsberg W, Inciardi JA, Compton WM, Ben Abdallah A, Cunningham-Williams R, Woodson S. Effectiveness of HIV risk reduction initiatives among out-of-treatment non-injection drug users. J Psychoactive Drugs. 1998 Jul-Sep;30(3):279–290. [PubMed]
  • Coyle SL, Needle RH, Normand J. Outreach-based HIV prevention for injecting drug users: a review of published outcome data. Public Health Rep. 1998 Jun;113 (Suppl 1):19–30. [PMC free article] [PubMed]
  • Holtgrave DR, Kelly JA. Preventing HIV/AIDS among high-risk urban women: the cost-effectiveness of a behavioral group intervention. Am J Public Health. 1996 Oct;86(10):1442–1445. [PubMed]
  • Kotranski L, Semaan S, Collier K, Lauby J, Halbert J, Feighan K. Effectiveness of an HIV risk reduction counseling intervention for out-of-treatment drug users. AIDS Educ Prev. 1998 Feb;10(1):19–33. [PubMed]
  • Leshner AI. HIV prevention with drug using populations. Current status and future prospects. Public Health Rep. 1998 Jun;113 (Suppl 1):1–3. [PMC free article] [PubMed]
  • McCoy HV, McCoy CB, Lai S. Effectiveness of HIV interventions among women drug users. Women Health. 1998;27(1-2):49–66. [PubMed]
  • Pinkerton SD, Holtgrave DR, DiFranceisco WJ, Stevenson LY, Kelly JA. Cost-effectiveness of a community-level HIV risk reduction intervention. Am J Public Health. 1998 Aug;88(8):1239–1242. [PubMed]
  • Stevens SJ, Estrada AL, Estrada BD. HIV sex and drug risk behavior and behavior change in a national sample of injection drug and crack cocaine using women. Women Health. 1998;27(1-2):25–48. [PubMed]
  • Wechsberg WM, Dennis ML, Stevens SJ. Cluster analysis of HIV intervention outcomes among substance-abusing women. Am J Drug Alcohol Abuse. 1998 May;24(2):239–257. [PubMed]
  • Wechsberg WM, Desmond D, Inciardi JA, Leukefeld CG, Cottler LB, Hoffman J. HIV prevention protocols: adaptation to evolving trends in drug use. J Psychoactive Drugs. 1998 Jul-Sep;30(3):291–298. [PubMed]

Articles from Health Services Research are provided here courtesy of Health Research & Educational Trust