Table 1.
Intervention | Target population | Effectiveness | Unit cost | Achievable coverage (%) |
---|---|---|---|---|
VMMC | Eligible men | 60% reduction in RoA | $68 per procedure | 80 |
BCC | Heterosexual men | 20% reduction in RoA | $63 pppy | 100 |
Low-risk women | 20% reduction in RoA | $63 pppy | 100 | |
FSW | 50% reduction in RoA | $28 pppy | 100 | |
MSM | 50% reduction in RoA | $28 pppy | 100 | |
Early ART | Heterosexual men | 70% reduction in RoT | $457 pppy | 33 |
Low-risk women | 70% reduction in RoT | $457 pppy | 33 | |
FSW | 70% reduction in RoT | $457 pppy | 66 | |
MSM | 70% reduction in RoT | $457 pppy | 66 | |
PrEP | Heterosexual men | 75% reduction in RoA | $95 pppy | 25 |
Low-risk women | 75% reduction in RoA | $95 pppy | 25 | |
FSW | 75% reduction in RoA | $95 pppy | 50 | |
MSM | 75% reduction in RoA | $95 pppy | 50 |
A unit cost is assigned to each intervention following the UNAIDS Fast Track framework [17]. For continuity with previous studies [23,24], we assume homogeneity of individual-level efficacies of early ART and PrEP with respect to risk. As this is not a forecast analysis, we do not include discounting of costs or effects, nor do we make assumptions about whether intervention costs would decrease [61] or increase [62] with scale.
VMMC, voluntary medical male circumcision; BCC, behaviour change communication; Early ART, antiretroviral therapy as prevention comprising outreach testing and offering of ART to all HIV-positive people; PrEP, pre-exposure prophylaxis; FSW, female sex workers; MSM, men who have sex with men; RoA, risk of HIV acquisition; RoT, risk of onward HIV transmission; pppy, per person per year.