A Portfolio Approach to HIV Control in South Africa

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  • Date/Time:
    • Thursday October 6, 2011 - Friday October 7, 2011
      11:00 am - 12:59 pm
  • Location: ISyE Executive classroom
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Summary Sentence: A Portfolio Approach to HIV Control in South Africa

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TITLE: A Portfolio Approach to HIV Control in South Africa

SPEAKER:  Elisa Long


Recent HIV studies have stimulated interest in implementing portfolios of partially effective programs.  Using a dynamic HIV epidemic model, we evaluate population-level health benefits and costs of alternative portfolios, given uncertainty in each program’s effectiveness at reducing transmission.  We determine the optimal allocation of resources to each intervention, given a budget constraint.  Using a Monte Carlo simulation, we perform a probabilistic sensitivity analysis on the effectiveness of each intervention, based on the sampling distribution obtained in each clinical trial.  We find that a comprehensive portfolio of expanded screening, antiretroviral treatment, male circumcision, tenofovir microbicide gel, and preventive vaccination could avert 2.3 million HIV cases in South Africa over 10 years, a 66% reduction in incidence.  This strategy doubles treatment initiation, decreases adult HIV prevalence from 18% to <10%, and adds 32 million quality-adjusted life years (QALYs), at a cost of $29 billion over 10 years (or approximately $100 per person per year).  The incremental cost-effectiveness is <$2,000 per QALY gained, assuming reasonable microbicide and vaccine costs.  A portfolio of modestly effective prevention programs could substantially reduce HIV incidence in South Africa, and is an economically efficient use of limited resources.

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School of Industrial and Systems Engineering (ISYE)

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  • Created By: Anita Race
  • Workflow Status: Published
  • Created On: Aug 3, 2011 - 3:57am
  • Last Updated: Oct 7, 2016 - 9:55pm