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 9: Introduction to Part II

Robert J. Brent


For a CBA to be undertaken there has to be an intervention effect to evaluate. For the purposes of this book, an intervention is anything that reverses what has contributed to HIV/AIDS and its effects on people’s lives. Thus, given that unprotected sex causes people to get HIV, then providing condoms to reduce the incidence of unprotected sex would be an intervention. When the sharing of needles contaminated by HIV transmits the disease, supplying clean needles would be another intervention. The first step then in examining CBAs of HIV interventions is to identify what has contributed to the progression of the disease. As we explained in Chapter 1, there are many causes of HIV. To avoid an encyclopedic list of everything that has played a role, we will organize our discussion in Part II of this book around the fundamental question of why there is so much more HIV/AIDS in countries in SSA that have experienced a generalized epidemic than in a country such as the United States where HIV is largely just in localized populations. Once we have established this, we will then look at a second HIV distributional question, that is, why is HIV prevalence in the African American community so much higher than the rest of the United States? By trying to answer these two distribution questions we can see exactly what is similar and what is different about the epidemics in Africa and the United States. In this chapter we first summarize the important facts regarding...

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