Evaluating the Evidence for Historical Interventions Having Reduced HIV Incidence : A Retrospective Programmatic Mapping Modelling Analysis - Synopsis Report 2016
This multi-country study focuses on evaluating whether ART scale-up and changes in sexual risk behavior have contributed to the declining trends of HIV incidence and prevalence. The World Bank, UNAIDS, UNFPA, WHO, the Global Fund, and Imperial Coll...
Main Authors: | , , , , , |
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Other Authors: | |
Format: | Report |
Language: | English en_US |
Published: |
World Bank, Washington, DC
2016
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Subjects: | |
Online Access: | http://documents.worldbank.org/curated/en/433151481108871251/Synopsis-report-2016 http://hdl.handle.net/10986/25763 |
Summary: | This multi-country study focuses on
evaluating whether ART scale-up and changes in sexual risk
behavior have contributed to the declining trends of HIV
incidence and prevalence. The World Bank, UNAIDS, UNFPA,
WHO, the Global Fund, and Imperial College London agreed
upon specific criteria used to identify Botswana, Dominican
Republic, Kenya, Malawi and Zambia as the five countries
engaged in this study. Within Botswana, there was strong
evidence that showed that ART and changes in sexual risk
behavior had an impact of averting 210,000 infections in
urban areas as 120,000 infections in rural areas
(1975-2012). This discrepancy between urban and rural area
results was thought to be due to geographical heterogeneity
in HIV epidemiology or lack of power in available data. The
changes in sexual risk behavior had a comparatively larger
impact on the epidemic than ART, averting approximately
460,000 cumulative infections between 1982 and 2015. ART
alone was found to be insufficient to explain the observed
trend (approx. 44,000 FSW infections averted, 33,000
Bataeyes, and 28,000 amongst MSM). Results from Kenya showed
that again that changes in sexual risk behavior, and to a
much lesser extent ART, had averted approximately 4,107,000
infections between 1980-2015. An important takeaway from
these results was that ART had marginal impact on prevalence
trends but that it has yet to be fully optimized. |
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