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Condom distribution: a cost–utility analysis

Objective: To explore the cost-effectiveness of a condom distribution programme. Methods: We conducted a cost-utility analysis of a social marketing campaign in which over 33 million condoms were made freely available throughout Louisiana. Surveys among 275,000 African Americans showed that condom use increased by 30%. Based on the estimated cost of the intervention and costs of HIV/AIDS-associated medical treatment, we estimated the quality-adjusted life years (QALYs) saved, and number of HIV infections averted by the programme. Results: The programme was estimated to prevent 170 HIV infections and save 1909 QALYs. Over $33 million in medical care costs were estimated to be averted, resulting in cost savings. Sensitivity analyses showed that these results were quite stable over a range of estimates for the main parameters. Condom increases as small as 2.7% were still cost-saving. Conclusion: Condom distribution is a community-level HIV prevention intervention that has the potential to reach large segments of the general population, thereby averting significant numbers of HIV infections and associated medical costs. The intervention is easy to scale up to large populations or down to small populations. The financial and health benefits of condom social marketing support making it a routine component of HIV prevention services nationally.