Abstract:
INTRODUCTION:With limited funds available, meeting global health targets requires countries to both mobilize and prioritize their health spending. Within this context, countries have recognized the importance of allocating funds for HIV as efficiently as possible to maximize impact. Over the past six years, the governments of 23 countries in Africa, Asia, Eastern Europe and Latin America have used the Optima HIV tool to estimate the optimal allocation of HIV resources. METHODS:Each study commenced with a request by the national government for technical assistance in conducting an HIV allocative efficiency study using Optima HIV. Each study team validated the required data, calibrated the Optima HIV epidemic model to produce HIV epidemic projections, agreed on cost functions for interventions, and used the model to calculate the optimal allocation of available funds to best address national strategic plan targets. From a review and analysis of these 23 country studies, we extract common themes around the optimal allocation of HIV funding in different epidemiological contexts. RESULTS AND DISCUSSION:The optimal distribution of HIV resources depends on the amount of funding available and the characteristics of each country's epidemic, response and targets. Universally, the modelling results indicated that scaling up treatment coverage is an efficient use of resources. There is scope for efficiency gains by targeting the HIV response towards the populations and geographical regions where HIV incidence is highest. Across a range of countries, the model results indicate that a more efficient allocation of HIV resources could reduce cumulative new HIV infections by an average of 18% over the years to 2020 and 25% over the years to 2030, along with an approximately 25% reduction in deaths for both timelines. However, in most countries this would still not be sufficient to meet the targets of the national strategic plan, with modelling results indicating that budget increases of up to 185% would be required. CONCLUSIONS:Greater epidemiological impact would be possible through better targeting of existing resources, but additional resources would still be required to meet targets. Allocative efficiency models have proven valuable in improving the HIV planning and budgeting process.
journal_name
J Int AIDS Socjournal_title
Journal of the International AIDS Societyauthors
Stuart RM,Grobicki L,Haghparast-Bidgoli H,Panovska-Griffiths J,Skordis J,Keiser O,Estill J,Baranczuk Z,Kelly SL,Reporter I,Kedziora DJ,Shattock AJ,Petravic J,Hussain SA,Grantham KL,Gray RT,Yap XF,Martin-Hughes R,Beneddoi
10.1002/jia2.25097subject
Has Abstractpub_date
2018-04-01 00:00:00pages
e25097issue
4issn
1758-2652journal_volume
21pub_type
杂志文章,评审abstract:INTRODUCTION:Oral pre-exposure prophylaxis (PrEP) is a promising new prevention approach for those most at risk of HIV infection. However, there are concerns that behavioural disinhibition, specifically reductions in condom use, might limit PrEP's protective effect. This study uses the case of female sex workers (FSWs)...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.7448/IAS.20.1.21744
更新日期:2017-09-20 00:00:00
abstract:INTRODUCTION:We report the SVR12 final analysis of a phase 3 study of telaprevir in combination with peginterferon (P)/ribavirin (R) in HCV-genotype 1, treatment-naïve and -experienced patients with HCV/HIV co-infection (INSIGHT). MATERIALS AND METHODS:Patients receiving stable, suppressive HIV antiretroviral (ARV) th...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.7448/IAS.17.4.19626
更新日期:2014-11-02 00:00:00
abstract:INTRODUCTION:Evidence suggests that people who inject drugs often begin their drug use and injecting practices in adolescence, yet there are limited data available on the HIV epidemic and the responses for this population. The comprehensive package of interventions for the prevention, treatment and care of HIV infectio...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.7448/IAS.18.2.19442
更新日期:2015-02-26 00:00:00
abstract:INTRODUCTION:HIV self-testing (HIVST) offers an alternative to facility-based HIV testing services, particularly for populations such as men who have sex with men (MSM) who may fear accessing testing due to stigma, discrimination and criminalization. Innovative HIV testing approaches are needed to meet the goal of 90% ...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.1002/jia2.25124
更新日期:2018-07-01 00:00:00
abstract:INTRODUCTION:In 2014 the Joint United Nations Programme on HIV/AIDS defined the ambitious 90-90-90 targets for 2020, in which 90% of people living with HIV must be diagnosed, 90% of those diagnosed should be on sustained therapy and 90% of those on therapy should have an undetectable viral load. Children are considered...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章,评审
doi:10.7448/IAS.18.7.20236
更新日期:2015-12-02 00:00:00
abstract:BACKGROUND:Traditional medication adherence measures do not account for the pharmacokinetic (PK) properties of the drugs, potentially misrepresenting true therapeutic exposure. METHODS:In a population of HIV-infected Kenyan children on antiretroviral therapy including nevirapine (NVP), we used a one-compartment model ...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.7448/IAS.20.1.21157
更新日期:2017-06-15 00:00:00
abstract:INTRODUCTION:In 2012, the Supreme Court of Canada ruled that people living with HIV (PLWH) must disclose their HIV status to sexual partners prior to sexual activity that poses a "realistic possibility" of HIV transmission for consent to sex to be valid. The Supreme Court deemed that the duty to disclose could be avert...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章,评审
doi:10.7448/IAS.18.1.20572
更新日期:2015-12-22 00:00:00
abstract:INTRODUCTION:In 2016, the Global Health Sector Strategy (GHSS) on viral hepatitis called for elimination of viral hepatitis as a major public health threat by 2030 (i.e. 90% reduction in incidence and 65% in mortality). In 2017, WHO's first-ever Global Hepatitis Report presented the baseline values for each of the core...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章,评审
doi:10.1002/jia2.25050
更新日期:2018-04-01 00:00:00
abstract:BACKGROUND:Despite the centrality of family in Indian society, relatively little is known about family-based communication concerning sexual behaviour and HIV/AIDS in rural Indian families. To date, very few family-based adolescent HIV-prevention interventions have been developed for rural Indian youth. This study cond...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.1186/1758-2652-12-35
更新日期:2009-11-19 00:00:00
abstract:INTRODUCTION:The objective of this commentary is to review considerations for implementing routine viral load (VL) monitoring programmes for HIV-infected infants and children living in low- and middle-income countries (LMIC). Since 2013, the World Health Organization (WHO) guidelines recommend VL testing as the preferr...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.1002/jia2.25001
更新日期:2017-11-01 00:00:00
abstract:INTRODUCTION:Routes of transmission and reasons for HIV testing are important epidemiologic data to analyze the epidemic and to tailor the response to AIDS. The aim of this study was to analyze reasons for testing and transmission ways of HIV among recently diagnosed HIV patients registered in the multicenter HIV-TR co...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.7448/IAS.17.4.19595
更新日期:2014-11-02 00:00:00
abstract:INTRODUCTION:Women living with HIV experience a disproportionate burden of mental health issues. To date, global guidelines contain insufficient guidance on mental health support, particularly regarding perinatal care. The aim of this article is to describe the extent and impact of mental health issues as experienced b...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.7448/IAS.18.6.20289
更新日期:2015-12-01 00:00:00
abstract:INTRODUCTION:HIV-1 viral escape in the cerebrospinal fluid (CSF) despite viral suppression in plasma is rare [1,2]. We describe the case of a 50-year-old HIV-1 infected patient who was diagnosed with HIV-1 in 1995. Antiretroviral therapy (ART) was started in 1998 with a CD4 T cell count of 71 cells/ìL and HIV-viremia o...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.7448/IAS.17.4.19745
更新日期:2014-11-02 00:00:00
abstract:INTRODUCTION:The success of HIV treatment programmes globally has resulted in children with perinatally acquired HIV reaching adolescence in large numbers. The number of adolescents living with HIV is growing further due to persisting high HIV incidence rates among adolescents in low- and middle-income settings, partic...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章,评审
doi:10.1002/jia2.25002
更新日期:2017-11-01 00:00:00
abstract:INTRODUCTION:There is great interest for integrating care for non-communicable diseases (NCDs) into routine HIV services in sub-Saharan Africa (SSA) due to the steady rise of the number of people who are ageing with HIV. Suggested health system approaches for intervening on these comorbidities have mostly been normativ...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.1002/jia2.25508
更新日期:2020-06-01 00:00:00
abstract:INTRODUCTION:Outbreaks of hepatitis C virus (HCV) infections among HIV-positive men who have sex with men (MSM) have been observed globally. Using a multi-modelling approach we estimate the time and number of direct-acting antiviral treatment courses required to achieve an 80% reduction in HCV prevalence among HIV-posi...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.1002/jia2.25059
更新日期:2018-01-01 00:00:00
abstract:INTRODUCTION:T cell immunoglobulin and mucin domain (Tim) 3 and programmed death 1 (PD-1) are co-inhibitory receptors involved in the so-called T cell exhaustion, and in vivo blockade of these molecules restores T cell dysfunction. High expression of Tim-3 and PD-1 is induced after chronic antigen-specific stimulation ...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.7448/IAS.18.1.20078
更新日期:2015-10-19 00:00:00
abstract:INTRODUCTION:Globally, young gay, bisexual and other men who have sex with men (gbMSM) continue to experience disproportionately high rates of HIV and other sexually transmitted and blood-borne infections (STBBIs). As such, there are strong public health imperatives to evaluate innovative prevention, treatment and care...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章,评审
doi:10.1002/jia2.25017
更新日期:2017-11-01 00:00:00
abstract:INTRODUCTION:Women living with HIV are required to transition into the prevention of mother-to-child transmission of HIV (PMTCT) services when they become pregnant and back to ART services after delivery. Transition can be a vulnerable time when many women are lost from HIV care yet there is little guidance on the opti...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章,评审
doi:10.1002/jia2.25633
更新日期:2021-01-01 00:00:00
abstract:INTRODUCTION:Young women aged 15 to 24 years in sub-Saharan Africa continue to be disproportionately affected by HIV. A growing number of studies have suggested that the practice of transactional sex may in part explain women's heightened risk, but evidence on the association between transactional sex and HIV has not y...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章,meta分析,评审
doi:10.7448/IAS.19.1.20992
更新日期:2016-11-02 00:00:00
abstract:INTRODUCTION:Population-level improvements in knowledge about HIV may reduce the stigma attached to HIV and ensure maximal uptake of HIV prevention initiatives. The extent to which levels of HIV knowledge in the general population of sub-Saharan Africa have changed in the current era of antiretroviral therapy (ART) sca...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.1002/jia2.25169
更新日期:2018-07-01 00:00:00
abstract:INTRODUCTION:Linkage from HIV testing and counselling (HTC) to initiation of antiretroviral therapy (ART) is suboptimal in many national programmes in sub-Saharan Africa, leading to delayed initiation of ART and increased risk of death. Reasons for failure of linkage are poorly understood. METHODS:Semi-structured qual...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.7448/IAS.15.2.18020
更新日期:2012-12-31 00:00:00
abstract:INTRODUCTION:Current healthcare systems fail to provide adequate HIV services to men. In Zambia, 25% of adult men living with HIV were unaware of their HIV status in 2018, and 12% of those who were unaware of their HIV statu were not receiving antiretroviral therapy (ART) due to pervasive barriers to HIV testing servic...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.1002/jia2.25520
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:Diagnosis of primary HIV infection (PHI) has important clinical and public health implications. HAART initiation at this stage remains controversial. METHODS:Our objective was to identify predictors of disease progression among Argentinean seroconverters during the first year of infection, within a multicen...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.1186/1758-2652-14-40
更新日期:2011-08-10 00:00:00
abstract:INTRODUCTION:Mortality among HIV-positive adults awaiting antiretroviral therapy (ART) has previously been found to be high. Here, we compare adolescent pre-ART mortality to that of adults in a public sector HIV care programme in Bulawayo, Zimbabwe. METHODS:In this retrospective cohort study, we compared adolescent pr...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.7448/IAS.18.1.19247
更新日期:2015-02-23 00:00:00
abstract:INTRODUCTION:HIV continues to devastate the adolescent population in sub-Saharan Africa (SSA). The complex array of interpersonal, social, structural and system-level obstacles specific to adolescents have slowed progress in prevention and treatment of HIV in this population. The field of implementation science holds p...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.1002/jia2.25572
更新日期:2020-09-01 00:00:00
abstract:INTRODUCTION:Consistent use of PrEP reduces HIV transmission from sexual practices amongst men who have sex with men (MSM) up to 92% [1]. Lisbon MSM cohort study estimates point that 59.3% of their participants at entrance (1593 HIV negative MSM enrolled between April 2011 and May 2013) were eligible for PrEP [2], acco...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.7448/IAS.17.4.19734
更新日期:2014-11-02 00:00:00
abstract:: The question of whether to initiate ART at higher CD4+ cell counts than currently recommended by World Health Organization (WHO) treatment guidelines received much attention at the XVII International AIDS Conference (AIDS 2008). If studies presented at the conference ultimately lead to a revision of WHO treatment gui...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.1186/1758-2652-12-S1-S4
更新日期:2009-10-06 00:00:00
abstract:INTRODUCTION:Stigma associated with HIV has been documented as a barrier for accessing quality health-related services. When the stigma manifests in the health care setting, people living with HIV receive substandard services or even be denied care altogether. Although the consequences of HIV stigma have been documente...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章,随机对照试验
doi:10.7448/IAS.16.3.18670
更新日期:2013-11-13 00:00:00
abstract:INTRODUCTION:People living with HIV (PLHIV) have the right to exercise voluntary choices about their health, including their reproductive health. This commentary discusses the integral role that family planning (FP) plays in helping PLHIV, including those in serodiscordant relationships, achieve conception safely. The ...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章,评审
doi:10.7448/IAS.20.2.21312
更新日期:2017-03-08 00:00:00