Setting Priorities for HIV/AIDS Interventions
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Setting Priorities for HIV/AIDS Interventions

A Cost–Benefit Approach

Robert J. Brent

HIV/AIDS is much too complex a phenomenon to be understood only by reference to common sense and ethical codes. This book presents the cost–benefit analysis (CBA) framework in a well-researched and accessible manner to ensure that the most important considerations are recognized and incorporated.
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Chapter 4: Counterintuitive Results

Robert J. Brent


We have just seen in the previous chapter that there is a lot of misinformation about HIV/AIDS. Even when we obtain the correct information, we may not make the best use of the information if we go straight to conclusions without going through a systematic evaluation exercise using the data. Let us look at some strategies that intuitively would seem to make a lot of sense as ways of preventing the spread of HIV, but do not end up as furthering the cause. In each case we explain the logic and why the facts may not fit the logic. ABSTINENCE Consider a country in which there are two groups: a high-risk group that has ten or more partners and a low-risk group with one sex partner. Given that those in the high-risk group have more partners than those in the low-risk group, they are more likely to be HIV positive than those in the low-risk group who are more likely to be HIV negative. Persons in the high-risk group have sex with others in the high-risk group, but they also have sex with persons in the low-risk group. Those in the lowrisk group partner only people in the high-risk group. As a result of all the pairings that have one partner HIV positive and one partner HIV negative, there is a national HIV prevalence rate of, say, X percent. Now introduce an informational program that encourages abstinence. If the program has an impact only on persons in the low-risk group,...

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