Do Less Harm: Evaluating HIV Programmatic Alternatives in Response to Cutbacks in Foreign Aid.

ABSTRACT:

Background

Resource-limited nations must consider their response to potential contractions in international support for HIV programs.

Objective

To evaluate the clinical, epidemiologic, and budgetary consequences of alternative HIV program scale-back strategies in 2 recipient nations, the Republic of South Africa (RSA) and Côte d'Ivoire (CI).

Design

Model-based comparison between current standard (CD4 count at presentation of 0.260 × 109 cells/L, universal antiretroviral therapy [ART] eligibility, and 5-year retention rate of 84%) and scale-back alternatives, including reduced HIV detection, no ART or delayed initiation (when CD4 count is <0.350 × 109 cells/L), reduced investment in retention, and no viral load monitoring or second-line ART.

Data sources

Publish

SUBMITTER: Walensky RP 

PROVIDER: S-EPMC5675810 | biostudies-literature | 2017 Nov

REPOSITORIES: biostudies-literature