Relative Costs, Health Outcomes and Cost- Effectiveness of HIV/AIDS Interventions in Rural and Urban Areas in South Africa

Abstract

The literature has long argued that the effectiveness
of HIV/AIDS interventions depends on the contexts of their
implementation. However, estimates of the relative costs,
effectiveness and cost-effectiveness of HIV/AIDS interventions in
socio-economic contexts such as rural and urban areas in South
Africa are insufficient to guide policy makers in resource
allocations. This paper uses Markov states transition models to
provide and compare such estimates for prevention of mother-tochild
transmission (PMTCT), highly active antiretroviral therapy
(HAART) for adults, and HAART for children. Data for the
baseline costs and health outcomes are collected in the literature.
To capture the effect of a given HIV/AIDS intervention and the
area of its implementation, transitions in HIV/AIDS states over
time are pegged to projections of Spectrum Policy Modeling
System in that area. The results suggest that the extent to which
cost-effectiveness of HIV/AIDS interventions across a rural area
and an urban area are different is great. Policy makers should
allocate resources according to these CE variations.