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An economic model of cost effectiveness of peer interventions to prevent HIV infections in prison


  • Roberta Longo

    () (Leeds Institute of Health Sciences, University of Leeds)

  • Claire Hulme

    (Leeds Institute of Health Sciences, University of Leeds)

  • Armando Vargas-Palacios

    (Leeds Institute of Health Sciences, University of Leeds)

  • Karen Vinall-Collier

    (Leeds Institute of Health Sciences, University of Leeds)

  • Jane South

    (Leeds Metropolitan University)

  • Anne Marie Bagnall

    (Leeds Metropolitan University)

  • James Woodall

    (Leeds Metropolitan University)

  • Gary Raine

    (Leeds Metropolitan University)

  • Karina Kinsella

    (Leeds Metropolitan University)


Aim: To assess the cost-effectiveness of peer-based sexual behaviour education interventions in prison settings to prevent primary and secondary HIV infections. Methods: Based on the results of a systematic review of peer-based interventions in prison settings, we developed a Bernoulli model to estimate the number of HIV infections averted, consequent loss of quality-adjusted life years (QALYs) avoided and associated savings in health care costs over a lifetime respectively for a peer-led and a professionally-led education intervention. Results: The economic model showed that peer-led and professionally-led educational interventions prevent future HIV infections among offenders in prison settings, thus saving a significant amount of health care costs compared to a ‘do nothing’ scenario. In addition the peer-led intervention is dominant when compared to the professionally-led intervention (it is more effective and less costly). Whilst the model is surrounded by considerable uncertainty, the dominance scenario is confirmed in the one-way and probabilistic sensitivity analysis conducted. Conclusions: This study adds to previous evidence on the effectiveness of peer based educational interventions in preventing HIV in prison by showing that these are not only more effective but also cost less than the professionally-led alternative.

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  • Roberta Longo & Claire Hulme & Armando Vargas-Palacios & Karen Vinall-Collier & Jane South & Anne Marie Bagnall & James Woodall & Gary Raine & Karina Kinsella, 2014. "An economic model of cost effectiveness of peer interventions to prevent HIV infections in prison," Working Papers 1402, Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds.
  • Handle: RePEc:lee:wpaper:1402

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    References listed on IDEAS

    1. Andrew Briggs & Taane Clark & Jane Wolstenholme & Philip Clarke, 2003. "Missing.... presumed at random: cost-analysis of incomplete data," Health Economics, John Wiley & Sons, Ltd., vol. 12(5), pages 377-392.
    2. Patrick Royston, 2005. "Multiple imputation of missing values: Update of ice," Stata Journal, StataCorp LP, vol. 5(4), pages 527-536, December.
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    Cost-effectiveness analysis; HIV; prevention in prison; sexual behaviour; peer education;

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