|
|
Abstract
Use of a simple projection model for estimating enrollment targets in HIV care and treatment programs in low-income countries
A Thompson, D Hoos, L Meyer, T Hardy, W El-Sadr
MTCT-Plus Initiative, Mailman School of Public Health, Columbia University, New York City, United States
Background: Given the fluctuation of prices for antiretroviral (ARV) medication available to low-income countries, managers of HIV care and treatment programs - constrained by fixed budgets - need ready access to information in order to continuously maximize enrollment targets. In response the MTCT-Plus Initiative of the Mailman School of Public Health, Columbia University developed a simple, user-friendly projection model that estimates enrollment targets by calculating clinic costs and updating ARV prices and drug-use patterns.
Methods: The MTCT-Plus Initiative established 12 sites in 8 African countries and Thailand to provide care and treatment to HIV-infected families identified through programs for the prevention of mother to child transmission of HIV. Model calculations are based on two sets of parameters: 1) the cost of program resources including clinic facilities, labor, training and medication and 2) the use of ARV medication including rates of ARV uptake, retention/mortality, toxicity, drug-switching and failure. Default parameters are based on MTCT-Plus data, but all parameters can be adapted to different settings and populations as needed.
Results: With other factors constant, the model indicated that the 50% decrease in the average price of first-line ARV medication in 2003 would allow a typical MTCT-Plus site to increase total enrollment by 33% or 230 people. MTCT-Plus used the model to analyze its resource capacity and to re-assess its enrollment targets and policies.
Conclusion: This model confirms the importance of labor, ARV prices and program retention in the costs of HIV treatment programs. It also shows that the rate of switching from first to second-line ARV regimens is a crucial factor in determining enrollment targets, as second-line medication is much more costly. More generally, the model is useful for program managers who seek to maximize enrollment targets based on up-to-date data on program cost and clinical outcomes.
The XV International AIDS Conference
Abstract no.
TuPeD5147
Suggested Citation
" A Thompson, et al.
Use of a simple projection model for estimating enrollment targets in HIV care and treatment programs in low-income countries.
Poster Exhibition:
The XV International AIDS Conference:
Abstract no.
TuPeD5147"
|
|
|