Cost-Effectiveness of HIV Prevention Strategies
Summary
Cost-effectiveness analysis in HIV prevention seeks to determine how best to allocate limited resources to avert new infections, improve health outcomes and avert disability within diverse epidemic settings. Interventions under evaluation include antiretroviral therapy (ART) for treatment and prevention, oral and long-acting injectable pre-exposure prophylaxis (PrEP), male circumcision, behavioural and structural approaches. By modelling the impact of these interventions on incidence, disability-adjusted life-years (DALYs) and quality-adjusted life-years (QALYs), analysts identify which strategies provide the greatest health gain per unit cost. Evidence indicates that targeting high-risk populations with PrEP or early ART can be highly cost-effective when adherence and coverage are optimised, and that combining immediate low-cost measures (such as male circumcision and test-and-treat programmes) with emerging technologies (for example long-acting drugs or vaccines) can maximise prevention impact. Cost thresholds and budget impacts vary by setting, depending on drug prices, healthcare infrastructure and population risk profiles. Harmonised monitoring frameworks and dynamic modelling support decision-makers in comparing prevention portfolios and adapting strategies as local epidemics evolve.
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Cost-Effectiveness of HIV Prevention Strategies publication trend
The graph below shows the total number of articles in cost-effectiveness of hiv prevention strategies across all publications each year (not limited to Nature Index journals).
Technical terms
Pre-exposure prophylaxis (PrEP): use of antiretroviral drugs by uninfected individuals to prevent HIV acquisition.
Antiretroviral therapy (ART): medical treatment of HIV-positive people with drug combinations to suppress viral replication and reduce transmission.
Incremental cost-effectiveness ratio (ICER): additional cost per additional health outcome unit (for example per QALY or DALY averted) when comparing two interventions.
Disability-adjusted life-year (DALY): summary measure combining years of life lost and years lived with disability, used to quantify overall disease burden.
Quality-adjusted life-year (QALY): measure that accounts for both quantity and quality of life lived, used to assess the value of medical interventions.
References
- Health impact, budget impact, and price threshold for cost-effectiveness of lenacapavir for HIV pre-exposure prophylaxis in eastern and southern Africa: a modelling analysis. The Lancet HIV (2024).
- Developing evidence-informed indicators to monitor HIV pre-exposure prophylaxis programmes across EU/EEA countries: a multi-stakeholder consensus. Eurosurveillance (2023).
- Maximising HIV prevention by balancing the opportunities of today with the promises of tomorrow: a modelling study. The Lancet HIV (2016).
- Estimation of the cost-effectiveness of HIV prevention portfolios for people who inject drugs in the United States: A model-based analysis. PLOS Medicine (2017).
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