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Resource Needs for Prevention. Types of prevention. 14 prevention interventions, including: Youth focused interventions Interventions focused on sex workers and their clients Condom provision (commercial and public) Improving STI management Voluntary Counseling and Testing

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Presentation Transcript
types of prevention
Types of prevention
  • 14 prevention interventions, including:
    • Youth focused interventions
    • Interventions focused on sex workers and their clients
    • Condom provision (commercial and public)
    • Improving STI management
    • Voluntary Counseling and Testing
    • Workplace programs
    • Blood safety
    • Prevention of mother-to-child transmission
    • Mass media
    • Harm reduction programs
    • Interventions focused on men who have sex with men
    • Post-exposure prophylaxis
    • Safe injections
    • Universal precautions
basic principles
Basic principles
  • Three factors:
    • Population target group
    • Access
    • Per patient cost (annual or life-time)
  • Total cost = Persons needing treatment X

% needing treatment with access to it X

unit cost of the treatment

people needing care
People needing care
  • The annual cohort that requires attention are those people living with HIV who are newly symptomatic
  • Plus:
    • Survivors on treatment
    • Survivors without treatment
one time costs
One-time costs
  • Palliative and OI treatment costs
    • Lifetime costs counted once
  • HIV testing
    • One-time cost for diagnosis prior to OI treatment
    • Default unit cost include counseling costs
ongoing treatment
Ongoing treatment
  • Those needing ongoing treatment (ARV and OI prophylaxis) include:
    • Percentage of newly symptomatic
    • 100% of those treated last year who survive
current access
Current access
  • Palliative care coverage is estimated using access to other health services
  • OI tx, OI prophylaxis & ARV estimated from coverage survey (and 3x5 data)
growth rates
Growth rates
  • Once the baseline has been estimated, growth capacity of services are estimated
  • Growth rates estimated using growth between 2004 and 2005
  • Maximum feasible coverage defined at 85%
  • Cap on coverage affects newly needing but not survivors on treatment
how many years
How many years?
  • Expected life extension is uncertain
  • Model assumes 3-5 additional years of life from ARVs
total costs
Total costs
  • Total costs = The number of persons receiving treatment for each year (newly requiring treatment plus those surviving, if relevant) * per patient cost of treatment
regional distribution 2008
Regional distribution, 2008

1%

7%

15%

55%

17%

5%

Africa

S/SE Asia

E Asia/Pac

LAC

E Europe

NA/ME

distribution by intervention 2008
Distribution by intervention, 2008

2%

6%

<1%

13%

10%

69%

Palliative

Testing

OI Tx

OI Proph

ARVs

ARVs Labs