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Cost-Effectiveness of Syringe Exchange as an HIV Prevention Strategy

Laufer Franklin N.
JAIDS Journal of Acquired Immune Deficiency Syndromes: November 1st, 2001
Article: PDF Only

Objective:To analyze the cost-effectiveness of New York State-approved syringe exchange programs (SEPs) and estimate the cost-saving potential of these programs.

Design and Methods:The cost-effectiveness analysis used cost and process data provided by seven SEPs for the calendar year 1996 or the most recent 12-month period available at the time of the study. Alternative estimates of the number of HIV infections prevented were calculated using published data and a simplified circulation model. HIV treatment costs were taken from the literature.

Results:A cost-effectiveness ratio of $20,947 per HIV infection averted was calculated based on an estimated 87 HIV infections averted across the seven programs and total program costs of $1.82 million (all amounts given in US dollars). Sensitivity analyses were also performed. Using imputed costs for donated services and estimates of lifetime costs to treat an HIV infection, syringe exchange was demonstrated to be a cost-saving strategy from a societal perspective.

Conclusions:This research demonstrates that syringe exchange is a cost-effective and cost-saving strategy for reducing HIV transmission.

Address correspondence and reprint requests to Franklin N. Laufer, Ph.D., Division of HIV Prevention, AIDS Institute, New York State Department of Health, Empire State Plaza, Corning Tower Building, Room 241, Albany, NY 12237, U.S.A.; e-mail:

Manuscript received March 22, 2001; accepted July 23, 2001.

This research was conducted and the article was initially written while the author was on the staff of the Bureau of Health Economics, Division of Health Care Financing, New York State Department of Health. The views expressed are those of the author and do not necessarily reflect those of the New York State Department of Health.

© 2001 Lippincott Williams & Wilkins, Inc.