At present human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) is posing new challenges before healthcare providers world-wide, even though numerous programs have been formulated to prevent the spread of this disease from the very beginning of its identification. However, the epidemic is yet to be conquered, and, hence, evaluating the cost-effectiveness of various programs is crucial to assess the efficiency of different health interventions for HIV/AIDS prevention that is in operation since detecting the HIV epidemic. Since resources are scarce compared to the health care needs those responsible for allocating resources need to prioritize immediate challenges for getting maximum benefit from any given budget, as the basic aim of any healthcare system is to maximize the health and welfare of the population
Evaluation of any program, policy, or an activity is integral in assessing their effectiveness and anticipated final outcomes, as well as for modeling future strategies of any activity. Though there may be contextual difference in every activity the evaluation techniques applied are similar. However, the research approach should be appropriate to the subject context of the activity to be evaluated and the evaluators must scrutiny the reasons for evaluation and validate available information. The evaluation of a program generally involves "assessing one or more of five domains: (1) the need for the program, (2) the program's design, (3) its implementation and service delivery, (4) its impact or outcomes, and (5) its efficiency." (Rossi, Lipsey & Freeman, 2003, p.18). Success of a program evaluation depends on the evaluation plan drawn up by an evaluator that pragmatically addresses "evaluation purposes and audience, the nature of the program being evaluated, and not least, the political and organizational context within which the evaluation is conducted" (Rossi, Lipsey & Freeman, 2003, p.18). Evaluator's ability to understand the questions posed by the evaluation sponsor and stakeholders and capacity to negotiate with these will help refine and structure evaluation plan as well as streamlining evaluation questions. Above all, an evaluator must consider the intended purposes of the evaluation, whether it is for optimizing program's effectiveness, what are the benefits derived from the program, knowledge generated from the study, and identify any hidden agenda and conflicting interests of stake holders.
Since the first cases of acquired immunodeficiency syndrome (AIDS) were reported in the United States in June 1981 there was rapid increase in AIDS incidence, and an estimated 1.3 to 1.4 million persons in the United States were infected with human immunodeficiency virus (HIV), as well as 816,146 cases of AIDS and 467,910 deaths were reported to Centers for Disease Control (CDC) during the twenty years period from 1981 to 2001. (Advancing HIV prevention: New strategies for a changing epidemic---United States, 2003).
Identifying HIV as the cause of AIDS in 1983 facilitated the development of tests to detect the virus, which led to new initiatives and programs for quantifying the HIV epidemic and formulating prevention strategies. Though there are many effective strategies to control the spread of HIV, such as: blood screening services, promotion of condoms, mass media strategy for disseminating information to the general population with