Table 2.
Key model parameters
| Kenya | South Africa | Colombia | Ukraine | |||
|---|---|---|---|---|---|---|
| Population of pregnant women | 1 631 470 | 1 100 699 | 346 409 | 363 946 | ||
| HIV risk | ||||||
| HIV prevalence | 6·1% | 3·1% | 0·4% | 0·7% | ||
| Maternal HIV incidence rate (per person-week) | ||||||
| Before first ANC visit during pregnancy | 0·000331 | 0·000227 | 0·00001 | 0·000002 | ||
| Between first ANC visit and delivery | 0·000331 | 0·000739 | 0·00002 | 0·000004 | ||
| Delivery to 6 weeks post partum | 0 | 0 | 0 | 0 | ||
| 6 weeks to 12 months post partum | 0·000269 | 0·0009 | 0·00003 | 0·000003 | ||
| Duration of incident maternal HIV infection (weeks) | 9 | 9 | 9 | 9 | ||
| HIV testing and prevention | ||||||
| Test kit unavailable | 5·0% | 5·0% | 0·0% | 0·0% | ||
| Test acceptance | 84·0% | 98·0% | 89·0% | 97·2% | ||
| Received test results | 97·8% | 98·0% | 100·0% | 100·0% | ||
| HIV rapid test sensitivity in early infection | 66·7% | 66·7% | 66·7% | 66·7% | ||
| HIV rapid test sensitivity in chronic infection | 100·0% | 100·0% | 100·0% | 100·0% | ||
| HIV rapid test specificity | 98·9% | 98·9% | 98·9% | 98·9% | ||
| Dual test sensitivity in early infection | 66·7% | 66·7% | 66·7% | 66·7% | ||
| Dual test sensitivity in chronic infection | 100·0% | 100·0% | 100·0% | 100·0% | ||
| Dual test specificity | 98·9% | 98·9% | 98·9% | 98·9% | ||
| MTCT rate per week, acute maternal infection | 0·005–0·029 | 0·005–0·029 | 0·005–0·029 | 0·005–0·029 | ||
| MTCT rate per week, chronic maternal infection | 0·0005–0·023 | 0·0005–0·023 | 0·0005–0·023 | 0·0005–0·023 | ||
| Maternal PrEP use | 0·0% | 0·0% | 0·0% | 0·0% | ||
| Health-care visits | ||||||
| Attended first ANC visit | 96·0% | 94·0% | 97·4% | 99·8% | ||
| Attended late ANC visit | 92·7% | 78·0% | 88·1% | 90·0% | ||
| Facility delivery | 61·8% | 96·0% | 98·9% | 99·0% | ||
| Gestational age at first ANC visit (weeks) | 22 | 18 | 15 | 10 | ||
| Gestational age at late ANC visit (weeks) | 33 | 36 | 24 | 28 | ||
| Gestational age at delivery (weeks) | 39 | 39 | 39 | 39 | ||
| ARV coverage | ||||||
| Maternal ART use | 91·0% | 87·0% | 87·8% | 95·0% | ||
| Virally suppressed women with HIV | 88·1% | 72·0% | 88·4% | 88·1% | ||
| Weekly ART dropout (%) | 0·3% | 0·3% | 0·3% | 0·3% | ||
| HIV-exposed infants receiving ARVs | 93·6% | 98·7% | 96·0% | 98·4% | ||
| HIV-infected infants receiving ART* | 61·0% | 63·0% | 57·9% | 95·0% | ||
| Breastfeeding | ||||||
| Not breastfeeding in early post partum (0–6 weeks) | 2·5% | 34·0% | 97·9% | 95·0% | ||
| Not breastfeeding in mid post partum (6 weeks to 6 months) | 21·2% | 45·0% | 97·9% | 99·0% | ||
| Not breastfeeding in late post partum (6–12 months) | 33·4% | 63·0% | 97·9% | 99·0% | ||
| Maternal mortality rate (per person-week) | ||||||
| During pregnancy | 0·0001 | 0·0001 | 0·00002 | 0·00002 | ||
| Delivery to 6 weeks post partum | 0·0006 | 0·0002 | 0·0001 | 0·00003 | ||
| 6 weeks to 12 months post partum | 0·0001 | 0·0001 | 0·00002 | 0·00002 | ||
| Neonatal and infant mortality (per person-week) and survival | ||||||
| Stillbirth, syphilis positive (mother not treated) | 21·0% | 21·0% | 21·0% | 21·0% | ||
| Stillbirth, syphilis positive (mother treated) | 3·8% | 3·8% | 3·8% | 3·8% | ||
| Neonatal mortality, birth to 6 weeks (mother had syphilis and not treated) | 9·0% | 9·0% | 9·0% | 9·0% | ||
| Neonatal mortality, birth to 6 weeks (mother had syphilis and treated) | 1·8% | 1·8% | 1·8% | 1·8% | ||
| Neonatal mortality, birth to 6 weeks (syphilis negative and HIV negative or HIV negative and on ART) | 0·5% | 0·3% | 0·2% | 0·1% | ||
| Infant mortality, >6 weeks to 12 months | 0·03% | 0·03% | 0·01% | 0·01% | ||
| Survival to 1 year, HIV negative or HIV positive and on ART | 96·4% | 96·7% | 98·7% | 99·2% | ||
| Survival to 1 year, HIV positive and not on ART | 64·8% | 64·8% | 64·8% | 64·8% | ||
| Syphilis | ||||||
| Syphilis prevalence | 1·2% | 2·0% | 0·41% | 2·5% | ||
| Maternal syphilis incidence rate (per person-week) | 0·00008 | 0·00008 | 0·00004 | 0·000015 | ||
| Laboratory-based test sensitivity for syphilis | 80·0% | 80·0% | 80·0% | 80·0% | ||
| Laboratory-based test specificity for syphilis | 100·0% | 100·0% | 100·0% | 100·0% | ||
| Dual RDT sensitivity for syphilis | 87·0% | 87·0% | 87·0% | 87·0% | ||
| Dual RDT specificity for syphilis | 99·5% | 99·5% | 99·5% | 99·5% | ||
| Test correction factor† | 52·9% | 52·9% | 52·9% | 52·9% | ||
| Test coverage (laboratory-based testing)‡ | 73·0% | 83·0% | 62·8% | 98·0% | ||
| Received treatment (laboratory-based testing) | 50·0% | 90·0% | 90·8% | 99·0% | ||
| Received treatment (dual testing) | 62·5% | 92·5% | 93·1% | 99·3% | ||
| HIV costs (US$) | ||||||
| Third generation rapid screening per woman | $2·64 | $7·72 | $6·68 | $3·99 | ||
| True-positive screening tests per woman* | $3·68 | $11·39 | $8·53 | $4·18 | ||
| False-positive screening tests per woman* | $26·39 | $34·17 | $74·83 | $19·80 | ||
| Maternal ART, per week per woman | $4·86 | $4·79 | $18·89 | $32·84 | ||
| Infant ARV prophylaxis (total cost) per infant | $2·32 | $3·82 | $52·10 | $4·00 | ||
| Maternal PrEP, per week per woman | $6·19 | $6·19 | $18·89 | $19·38 | ||
| Infant ART, per week per infant | $6·73 | $5·46 | $18·89 | $32·84 | ||
| Syphilis costs | ||||||
| RPR test screening per woman | $3·09 | $9·32 | $6·92 | $0·63 | ||
| TPHA test screening per woman | $0·59 | $3·04 | $3·43 | $1·14 | ||
| Dual test screening per woman | $5·79 | $8·69 | $8·21 | $1·99 | ||
| Benzathine benzylpenicillin injection, maternal treatment per woman | $0·64 | $0·60 | <$0·01 | $3·00 | ||
| Intravenous benzathine benzylpenicillin, infant treatment per infant | $1·42 | $1·42 | $1·42 | $1·42 | ||
| Paediatric inpatient, per day per infant | $8·41 | $72·81 | $62·87 | $28·84 | ||
Details and sources provided in appendix (pp 18–30). All costs reported in 2017 US$. ANC=antenatal care. ART=antiretroviral therapy. ARV=antiretrovirals. MCH=maternal and child health. MTCT=mother-to-child transmission. PrEP=pre-exposure prophylaxis. RDT=rapid diagnostic test. RPR=rapid plasma reagin. TPHA=Treponema pallidum hemagglutination assay.
*
Based on the percent of infants with early infant diagnosis.
†
Test correction factor is the probability that a woman who tested positive for syphilis has an active syphilis infection.
‡
Inclusive of stock-outs.