Preventing Perinatal Transmission of HIV--costs and Effectiveness of a Recommended Intervention

Overview

Journal Public Health Rep

Publisher Sage Publications

Specialty Public Health

Date 1996 Jul 1

PMID 8711101

Citations 9

Authors

R D Gorsky

P G Farnham

W L Straus

B Caldwell

D R Holtgrave

R J Simonds

M F Rogers

M E Guinan

Affiliations

Soon will be listed here.

Abstract

Objective: To calculate the national costs of reducing perinatal transmission of human immunodeficiency virus through counseling and voluntary testing of pregnant women and zidovudine treatment of infected women and their infants, as recommended by the Public Health Service, and to compare these costs with the savings from reducing the number of pediatric infections.

Method: The authors analyzed the estimated costs of the intervention and the estimated cost savings from reducing the number of pediatric infections. The outcome measures are the number of infections prevented by the intervention and the net cost (cost of intervention minus the savings from a reduced number of pediatric HIV infections). The base model assumed that intervention participation and outcomes would resemble those found in the AIDS Clinical Trials Group Protocol 076. Assumptions were varied regarding maternal seroprevalence, participation by HIV-infected women, the proportion of infected women who accepted and completed the treatment, and the efficacy of zidovudine to illustrate the effect of these assumptions on infections prevented and net cost.

Results: Without the intervention, a perinatal HIV transmission rate of 25% would result in 1750 HIV-infected infants born annually in the United States, with lifetime medical-care costs estimated at $282 million. The cost of the intervention (counseling, testing, and zidovudine treatment) was estimated to be $ 67.6 million. In the base model, the intervention would prevent 656 pediatric HIV infections with a medical care cost saving of $105.6 million. The net cost saving of the intervention was $38.1 million.

Conclusion: Voluntary HIV screening of pregnant women and ziovudine treatment for infected women and their infants resulted in cost savings under most of the assumptions used in this analysis. These results strongly support implementation of the Public Health Service recommendations for this intervention.

Citing Articles

Perinatal Antiretroviral Exposure and Prevented Mother-to-child HIV Infections in the Era of Antiretroviral Prophylaxis in the United States, 1994-2010.

Little K, Taylor A, Borkowf C, Mendoza M, Lampe M, Weidle P Pediatr Infect Dis J. 2016; 36(1):66-71.

PMID: 27749662 PMC: 5497572. DOI: 10.1097/INF.0000000000001355.

Economic issues in the prevention of vertical transmission of HIV.

Ades A, Ratcliffe J, Gibb D, Sculpher M Pharmacoeconomics. 2000; 18(1):9-22.

PMID: 11010608 DOI: 10.2165/00019053-200018010-00002.

The communicable disease impact of eliminating publicly funded prenatal care for undocumented immigrants.

Kuiper H, Richwald G, Rotblatt H, Asch S Matern Child Health J. 2000; 3(1):39-52.

PMID: 10728288 DOI: 10.1023/a:1021862113241.

Knowledge of treatment to reduce perinatal human immunodeficiency virus (HIV) transmission and likelihood of testing for HIV: results from two surveys of women of childbearing age.

Ruiz J, Molitor F Matern Child Health J. 2000; 2(2):117-22.

PMID: 10728267 DOI: 10.1023/a:1022944907256.

The maternal and child health sites' practices regarding HIV education, counseling, and testing of women of reproductive age in Chicago: barriers to universal implementation.

Rahimian A, Driscoll M, Taylor D Matern Child Health J. 2000; 2(1):35-44.

PMID: 10728257 DOI: 10.1023/a:1021893525536.

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