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Scaling up HIV prevention programs is cost effective
July 12, 2007Scaling up HIV prevention programs can increase efficiency and thus prevent more HIV infections, according to a study published in the online open access journal BMC Health Services Research. Each doubling of a program's scale can reduce costs by around a third, and some large programs are ten times more efficient than smaller ones - meaning that many more infections are averted for the same amount of resources.
"Proven prevention methods need to be scaled up rapidly," says Elliot Marseille, the project director and lead author of the report. "Therefore, the fact that costs tend to go down as scale goes up is good news. This could save millions of lives, as well as keeping in check the number of new patients requiring expensive anti-retroviral therapies."
Larger prevention programs use money more efficiently than smaller ones, analysis of the "Prevent AIDS: Network for Cost-Effectiveness Analysis" (PANCEA) project suggests. The study, funded by the US National Institutes of Health, seeks to improve HIV prevention funding allocation in low and middle-income countries.
Researchers at the University of California, San Francisco (UCSF) collaborated with local teams to collect recent cost and output data from 206 HIV prevention programs in India, Mexico, Russia, South Africa and Uganda. Six types of interventions were assessed including, voluntary counseling and prevention of mother-to-child transmission. And the team assessed relationship between scale (number of HIV prevention services provided) and unit cost (cost per unit of service).
The 'scale up - cost down' effect was seen across many countries and prevention approaches, with some large programs up to 100 times more cost effective than their smaller counterparts. But there is a threshold. When projects expand beyond a certain point, costs can start to rise - an effect noted in 2 types of HIV prevention interventions in India.
As more PANCEA-type data becomes available, researchers will be better able to predict these changes. "The global HIV prevention effort is rapidly increasing, with literally billions of dollars of spending anticipated in coming years." says James G. Kahn, the project's principal investigator. "We hope that research of this type will help programs better translate spending into HIV infections averted."
BioMed Central
Researchers at the University of California, San Francisco (UCSF) collaborated with local teams to collect recent cost and output data from 206 HIV prevention programs in India, Mexico, Russia, South Africa and Uganda. Six types of interventions were assessed including, voluntary counseling and prevention of mother-to-child transmission. And the team assessed relationship between scale (number of HIV prevention services provided) and unit cost (cost per unit of service).
The 'scale up - cost down' effect was seen across many countries and prevention approaches, with some large programs up to 100 times more cost effective than their smaller counterparts. But there is a threshold. When projects expand beyond a certain point, costs can start to rise - an effect noted in 2 types of HIV prevention interventions in India.
As more PANCEA-type data becomes available, researchers will be better able to predict these changes. "The global HIV prevention effort is rapidly increasing, with literally billions of dollars of spending anticipated in coming years." says James G. Kahn, the project's principal investigator. "We hope that research of this type will help programs better translate spending into HIV infections averted."
BioMed Central
HIV Prevention Current Events and HIV Prevention News RSSGlobal challenges and opportunities in fighting HIV/AIDS and neglected diseases
Responding to the HIV/AIDS pandemic and tackling so-called neglected tropical diseases are the focus of the November/December 2009 edition of Health Affairs.
Scientists learn why even treated genital herpes sores boost the risk of HIV infection
New research helps explain why infection with herpes simplex virus-2 (HSV-2), which causes genital herpes, increases the risk for HIV infection even after successful treatment heals the genital skin sores and breaks that often result from HSV-2.
Teens are heading in wrong direction: Likely to have sex, but not use contraception
Between 2003 and 2007, the progress made in the 1990s and early 2000s in improving teen contraceptive use and reducing teen pregnancy and childbearing stalled, and may even have reversed among certain groups of teens.
Herpes medication does not reduce risk of HIV transmission
A recently completed international multi-center clinical trial has found that acyclovir, a drug widely used as a safe and effective treatment to suppress herpes simplex virus-2 (HSV-2), which is the most common cause of genital herpes, does not reduce the risk of HIV transmission when taken by people infected with both HIV and HSV-2.
Gains in access to antiretroviral treatment come with some costs
In this week's PLoS Medicine magazine, Yibeltal Assefa, from the National HIV/AIDS Prevention and Control Office in Addis Ababa, and colleagues describe the successes and challenges of the scale-up of antiretroviral treatment (ART) across Ethiopia.
Adult circumcision reduces risk of HIV transmission without reducing sexual pleasure
Two studies presented at the 104th Annual Scientific Meeting of the American Urological Association (AUA) show that adult circumcision reduces the risk of contracting the human immunodeficiency virus (HIV) and the risk of coital injury¬¬--without reducing pleasure or causing sexual dysfunction.
Study details strategy for boosting ranks of black HIV/AIDS researchers
African Americans, who make up 13 percent of the U.S. population, are disproportionately affected by AIDS, accounting for nearly 49 percent of newly diagnosed HIV/AIDS cases nationwide. About 500,000 African Americans are now living with HIV/AIDS.
Clinical trial finds microbicide promising as HIV prevention method for women
A clinical trial involving more than 3,000 women in the U.S. and southern Africa demonstrates for the first time the promise of a vaginal microbicide gel for preventing HIV infection in women.
Anti-HIV gel shows promise in large-scale study in women
An investigational vaginal gel intended to prevent HIV infection in women has demonstrated encouraging signs of success in a clinical trial conducted in Africa and the United States.
South African policy on adolescents' rights to access condoms is causing confusion
In 2007, South Africa's new Children's Act came into effect, granting children 12 years and older a host of rights relating to reproductive health, including the right to access condoms.
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