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Research Brief

There are approximately 40,000 new HIV infections in the United States each year. The estimated average lifetime cost of treating one HIV infection is $195,000. Relative to the size and costliness of the epidemic, government funds for prevention are scarce. To help decisionmakers allocate funds effectively, the RAND Corporation developed a mathematical model of the cost of a wide variety of HIV prevention interventions. The model uses a constant total budget of $400 million annually, which is within the $415 million budgeted in 2004 to state and local health departments for HIV prevention. The most cost-effective interventions (those that prevented the largest number of infections per dollar spent) are shown in the table.

Cost-Effective Interventions to Prevent HIV Infections

Intervention People Reached Annual Cost of Intervention Infections Prevented Cost Per Infection Prevented
Educational videos in STD clinics 2,000,000 $2,700,000 580 $4,700
Notifying sexual partners 54,000 $13,500,000 2,230 $6,100
Community outreach (Mpowerment modela) 600,000 $109,096,000 8,921 $12,000
STD screening at HIV clinics 467,000 $18,680,000 1,606 $12,000
Implementing needle exchange in high-prevalence areas 1,000,000 $30,380,000 2,291 $13,000
Mass media campaigns 70,000,000 19,999,000 1,131 $18,000
Opinion leaders programs 600,000 $22,851,000 994 $23,000
Implementing needle exchange in medium-prevalence areas 600,000 $18,228,000 388 $47,000
Increasing condom availability/accessibility 24,905,725 $90,566,000 1,920 $47,000
HIV counseling and testing (one-on-one) 1,000,000 $74,000,000 700 $110,000
Total NA $400,000,000 20,761 NA

a This model allows gay people in each community to tailor and run the intervention. For more information, go to

  • The most cost-effective interventions are targeted at high-risk groups, such as men who have sex with men and users of intravenous drugs.
  • The single most effective intervention (potentially preventing nearly 9,000 infections per year) is community outreach using the Mpowerment model.
  • HIV patients who have other sexually transmitted diseases have a much greater risk of transmitting HIV to their sexual partners. Screening and treating HIV patients for other STDs can significantly reduce the incidence of HIV.
  • Interventions aimed at low-prevalence populations (such as mass media campaigns) can be cost-effective if they reach a large number of people.
  • Allocating funds across all ten interventions achieved the best results: prevention of an estimated 20,000 infections annually.

This report is part of the RAND research brief series. RAND research briefs present policy-oriented summaries of individual published, peer-reviewed documents or of a body of published work.

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