AIDS policy modeling: A social role for operations research

Some 17 million people worldwide are infected with HIV, the virus that causes AIDS. Since neither a cure nor a vaccine for HIV is likely in the near future, public health efforts have focused on treatment and prevention. Quantitative models have been used to support these efforts in a variety of ways. Biostatisticians have developed models to estimate epidemiological parameters of the infection. Epidemiologists have developed models to estimate HIV prevalence over time and to forecast the spread of the epidemic. A third area of enterprise, that of policy analysis and program evaluation, has not received as much attention, but is of critical importance, since many AIDS-related interventions have been implemented without adequate analysis of their costs and benefits. The focus of operations research is on making better decisions; thus, the main role for operations research in the AIDS arena is in policy analysis and program evaluation. That is the focus of this paper. We describe a number of models, ranging from simple to sophisticated, that illustrate how OR-based analyses have been and can be used to support better AIDS-related public health decisions. We highlight important areas for further analysis. We conclude with discussion of the broader context in which such models are used.