Economic Evaluations for HIV Prevention Programs for Adolescents
|P.I.||Mary Jane Rotheram, Ph.D|
|Current Contact||Dallas Swendeman|
Effective HIV preventive interventions have been developed and evaluated with adolescents (Jemmott, in press). CHIPTS investigators designed, mounted, and evaluated HIV prevention programs with four adolescent samples at high risk for HIV: runaway youth (n=312), gay youth (n=154), youth living with HIV (n=351), and youth with parents with AIDS (n=423 adolescents from 280 different families). Each of these samples reflects a sub-population at high risk of contracting or transmitting HIV; each is composed predominantly of African-American and Latino youth aged 12-20 years. For each population, an intervention was designed based on social learning theory that focused primarily on skill building and aimed at reducing sexual and substance use risk acts; each intervention also was tailored for the specific population. Each intervention was delivered in a small group setting, used tokens to encourage social rewards, and monitored affect by the use of a feeling thermometer. Homework assignments were common across interventions and multiple sessions were implemented. Each sample has been followed for at least two years; the assessment points for follow-up were at least 3, 6, 12, 18, and 24 months. The same research team designed the measures and the domains of assessment were similar. Each sample was assessed for sex and drug use.
While the field of HIV prevention has demonstrated that adolescents do reduce their sexual and substance use risk acts in response to intervention programs, there have been no evaluations of the cost effectiveness of these programs. This project, funded by the National Institute of Mental Health (NIMH), will evaluate the cost-effectiveness of each of the four adolescent prevention programs already mounted and compare the consistency of the cost-effectiveness findings across studies. The project consists of three phases. First, building on a cost-effectiveness analysis of the HIV intervention on runaway youth, this project is using the existing data to perform the cost-effectiveness analysis of the other three HIV intervention programs which were delivered to adolescents (youth living with HIV, gay youth, and youth whose parents living with AIDS). Second, the results of these four cost-effectiveness analyses are being used to examine the similarity and the consistency of the cost-effectiveness of different HIV-related intervention programs. Third, because HIV sex risk acts among adolescents are usually part of a cluster of problem behaviors, this project will expand current strategies for examining cost-effectiveness to include social outcomes such as foster care, mental health institutionalization, jail, and temporary shelter.