Cost effectiveness of Streetworks' needle exchange program of Edmonton.

OBJECTIVE To conduct a cost-effectiveness analysis of the Edmonton Streetworks needle exchange program, in terms of the additional cost per HIV infection averted. The main outcome measures were needle use with and without Streetworks, HIV cases averted, and program costs. METHODS We conducted interviews and HIV saliva tests on a sample of street-involved intravenous drug users (IDU) who are regular Streetworks' clients. Outcomes were used in a cost-effectiveness model. RESULTS It is projected that the program has a cost-effectiveness of $9,500 (Canadian) per HIV infection delayed for one year. CONCLUSIONS The discounted cost per case averted is less than the cost of a case of AIDS. Continuing the program is a dominant strategy.