Talebianpour Hamid, Hosseini-Shokouh Seyyed-Javad, Amiri-Ara Mohammad, Raei Mehdi, Hosseini-Shokouh Sayyed-Morteza
Student Research Committee, Baqiyatallah University of Medical Sciences, Tehran, Iran.
Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran.
HIV AIDS (Auckl). 2025 Aug 18;17:265-276. doi: 10.2147/HIV.S543292. eCollection 2025.
HIV/AIDS continues to pose a significant global health challenge, especially in low- and middle-income countries. Economic evaluations are essential to identify cost-effective prevention strategies and allocate limited healthcare resources efficiently.
This systematic review aimed to assess the cost-effectiveness of HIV prevention interventions across various populations and settings, and to evaluate the methodological quality of the included studies.
A comprehensive literature search was conducted in PubMed, Embase, Web of Science, and Scopus for English-language studies published between January 2003 and November 2023. The PRISMA guidelines were followed for the review process. The quality of the included studies was assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist.
Thirteen studies met the inclusion criteria, exhibiting diverse methodologies, target populations, and healthcare perspectives. The majority of studies reported that primary prevention methods-such as prenatal screening, harm reduction programs for drug users, and pre-exposure prophylaxis (PrEP) for high-risk groups-were more cost-effective than secondary or tertiary interventions. Study populations included pregnant women (38.4%), injection drug users (23.1%), men who have sex with men (23.1%), and general populations (15.4%). Overall, most studies demonstrated medium to high methodological quality.
Primary prevention strategies for HIV are generally cost-effective, especially when tailored to specific high-risk populations. However, more robust, context-specific evaluations are needed to support policy-making across diverse healthcare systems. Decision-makers should prioritize investment in early detection and preventive programs to optimize outcomes and resource use.
艾滋病毒/艾滋病仍然是一项重大的全球卫生挑战，尤其是在低收入和中等收入国家。经济评估对于确定具有成本效益的预防策略以及有效分配有限的医疗资源至关重要。
本系统评价旨在评估不同人群和环境中艾滋病毒预防干预措施的成本效益，并评估纳入研究的方法学质量。
在PubMed、Embase、科学网和Scopus中进行了全面的文献检索，以查找2003年1月至2023年11月发表的英文研究。审查过程遵循PRISMA指南。使用综合卫生经济评估报告标准（CHEERS）清单评估纳入研究的质量。
13项研究符合纳入标准，呈现出多样的方法、目标人群和医疗保健视角。大多数研究报告称，初级预防方法，如产前筛查、针对吸毒者的减少危害计划以及针对高危人群的暴露前预防（PrEP），比二级或三级干预措施更具成本效益。研究人群包括孕妇（38.4%）、注射吸毒者（23.1%）、男男性行为者（23.1%）和普通人群（15.4%）。总体而言，大多数研究显示出中等至高的方法学质量。
艾滋病毒的初级预防策略通常具有成本效益，尤其是针对特定高危人群量身定制时。然而，需要更有力的、针对具体情况的评估来支持不同医疗保健系统的决策制定。决策者应优先投资于早期检测和预防计划，以优化结果和资源利用。
