Cost-effectiveness of the Mpowerment Project, a community-level intervention for young gay men

Objectives: Previous evaluation demonstrated that the Mpowerment Project co mmunity-level intervention for young gay men reduces HIV risk behaviors. Th e Current analysis was undertaken to estimate the intervention's health and economic outcomes. Design/Methods: We conducted a retrospective cost-effectiveness analysis. W e estimated HIV infections averted. the gain in quality-adjusted life years (QALY,,), cost per infection averted, and net cost. Using a population-lev el model, we portrayed two epidemic scenarios: the first with stable HIV pr evalence and the other with rising MV prevalence. Inputs included behavior change resulting from the intervention and program cost data. Cost was calc ulated from three perspectives: societal societal excluding volunteer time. and that of a community-based organization (CBO). Outcomes were calculated for 1, 5 (baseline), and 20 years. Results: The Mpowerment Project averted an estimated 2.0 to 2.3 HIV infecti ons in the first year (according to the epidemic scenario), 5.0 to 6.2 over 5 years, and 9.2 to 13.1 over 20 years. The societal cost per HIV infectio n averted was estimated at between $14,600 and $18,300 over 5 years. Costs per infection averted were 28% lower when excluding volunteer time and 35% lower from the CBO perspective. Net savings were $700,000 to $900,000 over 5 years from the societal perspective. Conclusions: The Mpowerment Project is cost-effective compared with many ot her HIV prevention strategies, The cost per HIV infection prevented is far less than the lifetime medical costs of HIV disease.