The cost-effectiveness of expanding harm reduction activities for injecting drug users in Odessa, Ukraine

Sex Transm Dis. 2006 Oct;33(10 Suppl):S89-102. doi: 10.1097/01.olq.0000221335.80508.fa.


Objectives: The objectives of this study were to estimate the cost-effectiveness of a harm reduction intervention among injecting drug users (IDUs) in Odessa, Ukraine; and to explore how the cost-effectiveness changes if the intervention were scaled up to 60% as recommended by WHO/UNAIDS.

Study design: Economic providers' costs were estimated. A dynamic mathematical model, fitted to epidemiologic data, projected the intervention's impact. The cost per HIV infection averted for different intervention coverages was estimated.

Results: From September 1999 to August 2000, at the current coverage of between 20% to 38% and an injection drug user (IDU) HIV prevalence of 54%, projections suggest 792 HIV infections were averted, a 22% decrease in IDU HIV incidence, but a 1% increase in IDU HIV prevalence. Cost per HIV infection averted was $97. Scaling up the intervention to reach 60% of IDUs remains cost-effective and reduces HIV prevalence by 4% over 5 years.

Conclusion: At the current coverage, the harm reduction intervention in Odessa is cost-effective but is unlikely to reduce IDU HIV prevalence in the short-term. To reduce HIV prevalence, more resources are needed to increase coverage.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cost-Benefit Analysis
  • HIV Infections / epidemiology
  • HIV Infections / etiology
  • HIV Infections / prevention & control*
  • Health Care Costs*
  • Humans
  • Male
  • Models, Economic*
  • Prevalence
  • Substance Abuse, Intravenous / complications
  • Substance Abuse, Intravenous / economics*
  • Ukraine / epidemiology
  • Urban Population