Cost-effectiveness of harm reduction in preventing hepatitis C among injection drug users
- PMID: 11575485
- DOI: 10.1177/0272989X0102100502
Cost-effectiveness of harm reduction in preventing hepatitis C among injection drug users
Abstract
Objectives: Hepatitis C (HCV) has emerged as a major epidemic among injection drug users (IDUs), with observed prevalence exceeding 70% in many American and European cities. This article explores the potential of syringe exchange programs (SEPs) to reduce HCV incidence and prevalence.
Design: A random-mixing epidemiological model is used to examine the potential impact of harm reduction interventions.
Methods: Steady-state analysis is used to scrutinize the impact of SEP on HCV incidence and prevalence and to examine the accuracy of short-term incidence analysis in predicting long-run program effects.
Results: SEP is predicted to have little impact on HCV incidence and prevalence within realistic populations of IDUs.
Conclusions: Short-term incidence analysis substantially overstates SEP effectiveness and cost-effectiveness in preventing HCV. More comprehensive harm reduction models, coupled with referral of active IDUs to treatment, must complement syringe exchange to successfully contain highly infectious blood-borne diseases.
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