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Reviewing the evidence on effectiveness and cost-effectiveness of HIV prevention strategies in Thailand

DOI: 10.1186/1471-2458-10-401

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A systematic review of the national and international literature on HIV prevention strategies from 1997 to 2008 was undertaken. The outcomes used to consider the effectiveness of HIV prevention interventions were changes in HIV risk behaviour and HIV incidence. Economic evaluations that presented their results in terms of cost per HIV infection averted or cost per quality-adjusted life year (QALY) gained were also included. All studies were assessed against quality criteria.The findings demonstrated that school based-sex education plus life-skill programs, voluntary and routine HIV counselling and testing, male condoms, street outreach programs, needle and syringe programs, programs for the prevention of mother-to-child HIV transmission, male circumcision, screening blood products and donated organs for HIV, and increased alcohol tax were all effective in reducing HIV infection among target populations in a cost-effective manner.We found very limited local evidence regarding the effectiveness of HIV interventions amongst specific high risk populations. This underlines the urgent need to prioritise health research resources to assess the effectiveness and cost-effectiveness of HIV interventions aimed at reducing HIV infection among high risk groups in Thailand.Since the introduction of the universal health insurance coverage policy in 2001, Thailand has sought to further ensure efficient resource allocation in the health sector [1]. Evidence-based decision making requires that decisions about health and health care are based on best available information. To use such an approach it is necessary to appraise what constitutes evidence in relation to health-enhancing interventions. While the use of effectiveness information alone to justify health care resource allocation is still common practice, decision makers, academics and health care professionals are increasingly interested in cost-effectiveness data to guide policy making. Such evaluation are designed to guide ex

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