The economic implications of failing to meet the United States' HIV prevention goal of reducing new infections by 50 percent by 2005 are huge, researchers reported recently. This goal was set forth in a strategic plan by CDC in 2001. However, federal investment in HIV prevention has remained relatively unchanged in recent years, according to the report.

It has been estimated that an additional $300 million annually is required to meet the CDC goal of halving new HIV infections by 2005, according to Drs. David R. Holtgrave and Steven D. Pinkerton, the report's coauthors.

To examine the potential consequences of inadequate funding, the researchers conducted a cost-effectiveness analysis of reducing the current rate of 40,000 infections per year to 20,000 per year by 2005. Their analysis showed that investing an additional $383 million per year in HIV prevention efforts would save more than $18 billion in medical costs by the year 2010. Furthermore, cost savings will occur even if HIV prevention costs rise to $1.8 billion annually.

In an interview, Holtgrave, of Emory University in Atlanta, said that greater investment would be needed for expanded HIV counseling, testing and behavioral interventions in order to reach the CDC goal.

"This study underlines the importance of thinking about clinical prevention services when dealing with patients who are at risk or are already infected," Holtgrave added. Because of "prevention message burnout," it is paramount to "reinvent ways to get the message out" and to take into account current research findings when developing prevention programs, he said. For instance, he said, physicians should counter the common belief that there is a cure for HIV. Even if a vaccine is developed in the future, it is unlikely to be "perfectly protective," he added.

The full report, "Economic Implications of Failure to Reduce Incident HIV Infections by 50% by 2005 in the United States," is published in the June issue of the Journal of Acquired Immune Deficiency Syndromes (2003;33(2):171-174).

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