IDEAS home Printed from https://ideas.repec.org/a/sae/evarev/v24y2000i3p251-271.html
   My bibliography  Save this article

When is an HIV Infection Prevented and when is it Merely Delayed?

Author

Listed:
  • Steven D. Pinkerton

    (Center for AIDS Intervention Research, Medical College of Wisconsin)

  • Harrell W. Chesson

    (National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention)

  • David R. Holtgrave

    (National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention)

  • William Kassler

    (National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention)

  • Peter M. Layde

    (Department of Family and Community Medicine, Medical College of Wisconsin)

Abstract

HIV prevention programs are typically evaluated using behavioral outcomes. Mathematical models of HIV transmission can be used to translate these behavioral outcomes into estimates of the number of HIV infections averted. Usually, intervention effectiveness is evaluated over a brief assessment period and an infection is considered to be prevented if it does not occur during this period. This approach may overestimate intervention effectiveness if participants continue to engage in risk behaviors. Conversely, this strategy underestimates the true impact of interventions by assuming that behavioral changes persist only until the end of the intervention assessment period. In this article, the authors (a) suggest a simple framework for distinguishing between HIV infections that are truly prevented and those that are merely delayed, (b) illustrate how these outcomes can be estimated, (c) discuss strategies for extrapolating intervention effects beyond the assessment period, and (d) highlight the implications of these findings for HIV prevention decision making.

Suggested Citation

  • Steven D. Pinkerton & Harrell W. Chesson & David R. Holtgrave & William Kassler & Peter M. Layde, 2000. "When is an HIV Infection Prevented and when is it Merely Delayed?," Evaluation Review, , vol. 24(3), pages 251-271, June.
    • Handle: RePEc:sae:evarev:v:24:y:2000:i:3:p:251-271
    DOI: 10.1177/0193841X0002400301
    as

    Download full text from publisher

    File URL: https://journals.sagepub.com/doi/10.1177/0193841X0002400301
    Download Restriction: no
    File URL: https://libkey.io/10.1177/0193841X0002400301?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Mattson, M.E. & Pollack, E.S. & Cullen, J.W., 1987. "What are the odds that smoking will kill you?," American Journal of Public Health, American Public Health Association, vol. 77(4), pages 425-431.
    2. Holtgrave, D.R. & Kelly, J.A., 1996. "Preventing HIV/AIDS among high-risk urban women: The cost-effectiveness of a behavioral group intervention," American Journal of Public Health, American Public Health Association, vol. 86(10), pages 1442-1445.
    3. St Lawrence, J.S. & Brasfield, T.L. & Diaz, Y.E. & Jefferson, K.W. & Reynolds, M.T. & Leonard, M.O., 1994. "Three-year follow-up of an HIV risk-reduction intervention that used popular peers," American Journal of Public Health, American Public Health Association, vol. 84(12), pages 2027-2028.
    4. Pinkerton, S.D. & Holtgrave, D.R. & DiFranceisco, W.J. & Stevenson, L.Y. & Kelly, J.A., 1998. "Cost-effectiveness of a community-level HIV risk reduction intervention," American Journal of Public Health, American Public Health Association, vol. 88(8), pages 1239-1242.
    5. Siegel, J.E. & Weinstein, M.C. & Fineberg, H.V., 1991. "Bleach programs for preventing AIDS among IV drug users: Modeling the impact of HIV prevalence," American Journal of Public Health, American Public Health Association, vol. 81(10), pages 1273-1279.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Ana P. Johnson-Masotti & Purushottam W. Laud & Raymond G. Hoffmann & Matthew J. Hayat & Steven D. Pinkerton, 2001. "Probabilistic Cost-Effectiveness Analysis of HIV Prevention," Evaluation Review, , vol. 25(4), pages 474-502, August.
    2. David R. Holtgrave, 2004. "HIV Prevention, Cost-Utility Analysis, and Race/Ethnicity: Methodological Considerations and Recommendations," Medical Decision Making, , vol. 24(2), pages 181-191, March.
    3. Martin A. Andresen & Ehsan Jozaghi, 2012. "The Point of Diminishing Returns: An Examination of Expanding Vancouver’s Insite," Urban Studies, Urban Studies Journal Limited, vol. 49(16), pages 3531-3544, December.
    4. 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.
    5. Gregory S. Zaric & Margaret L. Brandeau & Paul G. Barnett, 2000. "Methadone Maintenance and HIV Prevention: A Cost-Effectiveness Analysis," Management Science, INFORMS, vol. 46(8), pages 1013-1031, August.
    6. Jenny Lye & Joe Hirschberg, 2004. "Alcohol consumption, smoking and wages," Applied Economics, Taylor & Francis Journals, vol. 36(16), pages 1807-1817.
    7. Stephanie Earnshaw & Katherine Hicks & Anke Richter & Amanda Honeycutt, 2007. "A linear programming model for allocating HIV prevention funds with state agencies: a pilot study," Health Care Management Science, Springer, vol. 10(3), pages 239-252, September.
    8. Crittenden, Kathleen S. & Kaponda, Chrissie P.N. & Jere, Diana L. & McCreary, Linda L. & Norr, Kathleen F., 2015. "Participation and diffusion effects of a peer-intervention for HIV prevention among adults in rural Malawi," Social Science & Medicine, Elsevier, vol. 133(C), pages 136-144.
    9. Juan Manuel Cabasés Hita & Eduardo Sánchez Iriso, 2002. "Costs and Effectiveness of a syringe distribution and needle exchange programme for HIV prevention in a regional setting," Documentos de Trabajo - Lan Gaiak Departamento de Economía - Universidad Pública de Navarra 0204, Departamento de Economía - Universidad Pública de Navarra.
    10. Kajal Lahiri & Jae G. Song, 2000. "The effect of smoking on health using a sequential self‐selection model," Health Economics, John Wiley & Sons, Ltd., vol. 9(6), pages 491-511, September.
    11. Kathleen J. Sikkema, 2005. "HIV Prevention among Women in Low-Income Housing Developments: Issues and Intervention Outcomes in a Place-Based Randomized Controlled Trial," The ANNALS of the American Academy of Political and Social Science, , vol. 599(1), pages 52-70, May.
    12. Zoë K. Harris, 2006. "Efficient allocation of resources to prevent HIV infection among injection drug users: the Prevention Point Philadelphia (PPP) needle exchange program," Health Economics, John Wiley & Sons, Ltd., vol. 15(2), pages 147-158, February.
    13. Ana P. Johnson-Masotti & Purushottam W. Laud & Raymond G. Hoffmann & Matthew J. Hayat & Steven D. Pinkerton, 2004. "A Bayesian Approach to Net Health Benefits: An Illustration and Application to Modeling HIV Prevention," Medical Decision Making, , vol. 24(6), pages 634-653, November.
    14. Juan Cabasés & Eduardo Sánchez, 2003. "Costs and effectiveness of a syringe distribution and needle exchange program for HIV prevention in a regional setting," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 4(3), pages 203-208, September.
    15. Haque, Samiul & Abedin, Naveen & Fakir, Adnan M. S. & Hannan, Rafe & Alam, Rafa, 2019. "Effects of smoking on agricultural productivity," 2019 Annual Meeting, July 21-23, Atlanta, Georgia 291149, Agricultural and Applied Economics Association.
    16. Steven D. Pinkerton & David R. Holtgrave & Laura C. Leviton & David A. Wagstaff & Paul R. Abramson, 1998. "Model-Based Evaluation of Hiv Prevention Interventions," Evaluation Review, , vol. 22(2), pages 155-174, April.
    17. Pierre‐Yves Crémieux & Pierre Ouellette & Caroline Pilon, 1999. "Health care spending as determinants of health outcomes," Health Economics, John Wiley & Sons, Ltd., vol. 8(7), pages 627-639, November.
    18. Melchior, Lisa A. & Huba, G. J. & Brown, Vivian B. & Slaughter, Ruth, 1999. "Evaluation of the effects of outreach to women with multiple vulnerabilities on entry into substance abuse treatment," Evaluation and Program Planning, Elsevier, vol. 22(3), pages 269-277, August.
    19. Margaret Brandeau & Gregory Zaric, 2009. "Optimal investment in HIV prevention programs: more is not always better," Health Care Management Science, Springer, vol. 12(1), pages 27-37, March.
    20. Kevin P. Brand & Jan M. Zielinski & Daniel Krewski, 2005. "Residential Radon in Canada: An Uncertainty Analysis of Population and Individual Lung Cancer Risk," Risk Analysis, John Wiley & Sons, vol. 25(2), pages 253-269, April.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:sae:evarev:v:24:y:2000:i:3:p:251-271. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: SAGE Publications (email available below). General contact details of provider: .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.