Optimizing the Allocation of Resources among HIV Prevention Interventions in Honduras
This paper presents a model that policymakers can use to determine the resource allocation that will prevent the maximum number of new HIV infections at any given budget level. The optimal allocation exercise was conducted in Honduras, where the ep...
| Main Authors: | , , , , |
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| Format: | Working Paper |
| Language: | English en_US |
| Published: |
World Bank, Washington, DC
2013
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| Subjects: | |
| Online Access: | http://documents.worldbank.org/curated/en/2002/06/3424559/optimizing-allocation-resources-among-hiv-prevention-interventions-honduras http://hdl.handle.net/10986/13689 |
| Summary: | This paper presents a model that
policymakers can use to determine the resource allocation
that will prevent the maximum number of new HIV infections
at any given budget level. The optimal allocation exercise
was conducted in Honduras, where the epidemic is still
concentrated in high-risk groups but has begun spreading
into the general population. Most transmissions occur
through heterosexual sex, followed by sex between men, and
mother-to-child transmission. Adult prevalence is estimated
at 1.4 percent. The optimization exercise involves several
steps:(a) choosing population subgroups targeted for
intervention; (b) estimating the proportion of each subgroup
that can be reached; (c) estimating the total number of new
infections expected in each subpopulation; (d) defining the
set of HIV prevention interventions to be considered; (e)
estimating the unit cost of each intervention; and (f)
estimating the expected effectiveness of each intervention.
Most of the data required to run the model has to be
guesstimated or derived from the literature. To address this
challenge, a group of some forty local and international
experts in HIV/AIDS met in Tegucigalpa in May 2002 and
arrived at the consensus estimates used in this exercise.
They based their estimates on data submitted by two local
epidemiologists who had conducted an extensive literature
search prior to the workshop. The results from this
collective exercise show that for limited HIV prevention
budgets (below $500,000), condom social marketing and condom
distribution prevent the maximum number of HIV infections.
If the HIV prevention budget is between $750,000 and $2.5
million, then Information Education and Communication (IEC)
targeted at high risk groups, HIV counseling and access to
rapid testing, and an information, education and
communications strategy (IEC) for the Garifunas should also
be part of the country's prevention strategy. The
exercise shows that some prevention interventions are
unattractive even when the HIV prevention budget increases
to $10 million.. |
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