A new study has found that larger HIV prevention programs in low and middle-income countries, like India, can enhance efficiency and cause program unit costs to reduce.
A UCSF-led team of researchers examined HIV prevention programs in India. Other low and middle-income countries like Uganda, South Africa, Mexico, Russia were also assessed.
"With the recent report from the Global HIV Prevention Working Group urging that funding for proven prevention programming double over the next three years, leading to billions of dollars in spending, we show that this additional funding could not only increase capacity but potentially also increase efficiency by lowering unit costs of prevention services. This means that more HIV infections may be averted," said the study's principal investigator, James G. Kahn, MD, MPH, professor at UCSF's Institute for Health Policy Studies and AIDS Research Institute.
In the study, researchers looked at six types of ongoing prevention interventions: voluntary counselling and testing, programs targeting sex workers, treatment for curable sexually transmitted diseases, information, education and communication initiatives, risk reduction programs for injection drug users and programs preventing transmission of HIV from mother to child.
"We found that, on average, each doubling of scale of a prevention program reduced unit costs by a third. Although our analysis is broad-some programs are inefficient because they are small while some programs are small because they are not well managed-rapidly ramping up well-run existing programs could have an immediate, startling effect in improving efficiency, reducing costs and containing the epidemic," said the study's lead author, Elliot Marseille, DrPH, MPP, a researcher at UCSF's Institute for Health Policy Studies.
The study is published in the online open access journal BMC Health Services Research.