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A Dynamic HIV-Transmission Model for Evaluating the Costs and Benefits of Vaccine Programs

Author

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  • Donna M. Edwards

    (Systems Research Department (MS-9201), Sandia National Laboratories, PO Box 969, Livermore, California 94551-0969)

  • Ross D. Shachter

    (Department of Engineering-Economic Systems and Operations Research, Stanford University, Stanford, California 94305)

  • Douglas K. Owens

    (VA Palo Alto Health Care System, 3801 Miranda Avenue, Palo Alto, California 94304 and Department of Medicine, Stanford University, Stanford, California 94305)

Abstract

We developed a dynamic model of HIV transmission to evaluate the costs and benefits of HIV-vaccine programs in a population of homosexual men. We examined how changes in high-risk sexual behavior and the growth pattern of the epidemic influence the cost-effectiveness of preventive vaccines and of therapeutic vaccines. We found that the effect of reductions in condom use is more important for therapeutic vaccines than for preventive vaccines. Therapeutic vaccines may increase HIV seroprevalence in the population, unless the vaccine program is accompanied by increased condom use. Epidemic growth patterns also influence the cost-effectiveness of both vaccines, but the effects are more pronounced for preventive vaccines, which are more cost-effective in an early-stage epidemic than in a late-stage epidemic.

Suggested Citation

  • Donna M. Edwards & Ross D. Shachter & Douglas K. Owens, 1998. "A Dynamic HIV-Transmission Model for Evaluating the Costs and Benefits of Vaccine Programs," Interfaces, INFORMS, vol. 28(3), pages 144-166, June.
    • Handle: RePEc:inm:orinte:v:28:y:1998:i:3:p:144-166
    DOI: 10.1287/inte.28.3.144
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    References listed on IDEAS

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    1. J.Robert Beck & Stephen G. Pauker, 1983. "The Markov Process in Medical Prognosis," Medical Decision Making, , vol. 3(4), pages 419-458, December.
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    Cited by:

    1. Duijzer, Lotty Evertje & van Jaarsveld, Willem & Dekker, Rommert, 2018. "Literature review: The vaccine supply chain," European Journal of Operational Research, Elsevier, vol. 268(1), pages 174-192.
    2. James G. Kahn & Margaret L. Brandeau & John Dunn-Mortimer, 1998. "OR Modeling and AIDS Policy: From Theory to Practice," Interfaces, INFORMS, vol. 28(3), pages 3-22, June.
    3. Lasry, Arielle & Zaric, Gregory S. & Carter, Michael W., 2007. "Multi-level resource allocation for HIV prevention: A model for developing countries," European Journal of Operational Research, Elsevier, vol. 180(2), pages 786-799, July.
    4. M S Rauner & S C Brailsford & S Flessa, 2005. "Use of discrete-event simulation to evaluate strategies for the prevention of mother-to-child transmission of HIV in developing countries," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 56(2), pages 222-233, February.
    5. Arielle Lasry & Stephanie Sansom & Katherine Hicks & Vladislav Uzunangelov, 2011. "A model for allocating CDC’s HIV prevention resources in the United States," Health Care Management Science, Springer, vol. 14(1), pages 115-124, March.

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