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June 5, 2003


Failed HIV Prevention Goals Could Cause $18 Billion In Economic Consequences For United States

ATLANTA -- Failure to reduce new HIV infections in the United States by 50 percent in the next two years not only will have substantial human consequences, but could cost the nation more than $18 billion. A study by Emory University Rollins School of Public Health professor David Holtgrave, PhD, analyzed the fiscal implications of the failure to meet this national goal set by the Centers for Disease Control and Prevention (CDC) in January 2001. The results are published in the June issue of the Journal of Acquired Immune Deficiency Syndrome.

Based on Dr. Holtgrave’s cost analysis, the failure to reduce new HIV infections by 50 percent by 2005 in the United States would result in 130,000 additional HIV infections between now and 2010, causing incurred net medical costs to grow to over $18 billion during the same time frame. Dr. Holtgrave and Steven Pinkerton, PhD, Medical College of Wisconsin, say that the human and fiscal stakes of meeting the CDC’s national HIV prevention goal are large enough to make it a top public health priority.

The CDC's fiscal year 2002 domestic HIV prevention budget totaled approximately $692 million. Studies have determined that an estimated $300 million to $334 million in additional resources would be needed for each of the following four fiscal years to reduce new infections by 50 percent. The resources could be used to expand HIV counseling and testing, behavioral risk reduction services for persons at risk of HIV infection through sexual or substance abuse, and intensive prevention services for persons already living with HIV infection. Assuming that the investment in such programs could hold down new infections to at least 20,000 per year, Dr. Holtgrave says, the U.S could save $18.453 billion through 2010.

For the past decade, however, the rate of new infections in the United States has remained largely unchanged at about 40,000 per year, and as of September 2002, the estimated number has not been modified by the CDC. Moreover, recent epidemiologic studies have actually shown increases of HIV-related risk behaviors and STDs in some communities. Given those factors, the researchers say, "It does appear a real possibility that the national HIV prevention goal might not be met by 2005."

"Many people been somewhat burned out by HIV prevention messages," Dr. Holtgrave says. "So too has our national investment in HIV prevention. Major, immediate expansions of science-based HIV prevention efforts are sorely needed to achieve the goal of reducing new HIV infections by 50%. Unfortunately, the time for meeting the 2005 goal is fast running out."

The paper was partially supported by the Center for Aids Research at Emory University, and a grant from the National Institute of Mental Health to the Medical College of Wisconsin.

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