osts of HIV Prevention Among Out of Treatment Drug Using Women: Results of a Randomized Controlled Trial

Presenter: Jennifer Ruger, Yale University

Abstract

When evaluating HIV interventions, accurate data on costs are essential for understanding resource consumption. Micro-costing is critical to determine the real costs of HIV interventions to improve precision of cost estimates for resource allocation. Previous studies have been unable to perform detailed micro-costing analyses. We developed a micro-costing method to estimate the real resource costs consumed by delivery of NIDA Cooperative Agreement Standard Intervention for HIV prevention plus two enhanced modules in a three-arm randomized controlled trial among drug using women (N=501). To our knowledge this is the first micro-costing study of the SI and enhanced modules and first of its kind targeting drug using women. Micro-costing was conducted alongside a three-arm randomized control trial to estimate costs of: (i) modified NIDA Cooperative Agreement Standard Intervention (SI); (ii) SI and a Well Women Exam (SI+WWE); and (iii) SI, Well-Woman Exam and 4 Educational Sessions (SI+ WWE+4ES) to prevent HIV/STDs in at risk, drug-using women in St Louis, Missouri. The cost of the standard NIDA intervention that all 501 participants received was $228 per person. The additional costs for the Well Woman Exam and 4 Educational sessions were and $156 and $943 per person, respectively. Total program costs for SI (501 persons) were $113,956; additional costs for SI+WWE (342 persons) were $53,400 and for SI+WWE+4ES (170 persons) were $160,231. Main cost component for both SI (64% of total costs) and SI+WWE (40% of total costs) was testing costs, whereas building and facilities costs was main cost component for SI+WWE+4ES (75% of total costs). This study provides accurate estimates of costs for standard and enhanced HIV interventions for policymakers seeking to implement targeted HIV prevention programs with scarce resources.