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Cost-effectiveness of an intervention for runaway youth.
Rotherram-Borus MJ; Lee M; Rotherram-Borus MJ; Gwadz M; University of
December 30, 1998
Int Conf AIDS. 1998;12:237 (abstract no. 14272). Unique Identifier :

BACKGROUND: The cost-effectiveness of an intensive HIV prevention program with demonstrated efficacy for runaway and homeless youth in shelters was evaluated over 2 years. METHODS: HIV-related sexual and substance-use risk acts were compared at 3, 6, 12, 18, and 24 months among 167 runaway adolescents from two shelters who received an intensive HIV intervention and 145 adolescents at two control shelters. The cost for delivering the intervention, the cost of an infection and the probability of an infection among runaways (4%), and the social costs of care in mental health facilities, health care settings, criminal justice settings, and foster care were monitored over two years. RESULTS: Significant reductions in the number of unprotected sexual acts, a weighted index of substance use, and the number of drugs used were found based on intervention condition and interactions of adolescents' gender and intervention condition. Alcohol and marijuana use also tended to be lower in the intervention group. Overall, females in the intervention group demonstrated greater reductions in sexual risk and substance use compared to males. Being older or pregnant were associated with substantially higher reports of sexual risk acts. African Americans reported greater reductions in substance use than other ethnic groups. Compared to the cost of delivering the program and the social costs, the intervention resulted in a 10% reduction in social costs over 2 years. The intervention appears cost-effective. CONCLUSION: The long-term efficacy and cost-effectiveness of delivering an HIV prevention program to youths at highest risk must be considered as a national policy issue.

MEETING ABSTRACTS Adolescence Cost of Illness Cost-Benefit Analysis Ethnic Groups/PSYCHOLOGY Female Foster Home Care/ECONOMICS Health Care Costs Health Policy Health Promotion/ECONOMICS/*ORGANIZATION & ADMIN Homeless Persons/*PSYCHOLOGY Human HIV Infections/ECONOMICS/EPIDEMIOLOGY/*PREVENTION & CONTROL Intervention Studies Los Angeles/EPIDEMIOLOGY Male Pregnancy Pregnancy in Adolescence/STATISTICS & NUMER DATA Program Evaluation Residential Facilities/ECONOMICS/STATISTICS & NUMER DATA Risk Factors *Risk-Taking *Runaway Behavior Sex Behavior/PSYCHOLOGY/*STATISTICS & NUMER DATA Sex Education/ECONOMICS/ORGANIZATION & ADMIN Substance-Related Disorders/EPIDEMIOLOGY/*PREVENTION & CONTROL Urban Population