Objective: There are an estimated 38 million people with HIV (PWH), with significant economic consequences. We aimed to collate global lifetime costs for managing HIV.
Design: We conducted a system...atic review (PROSPERO: CRD42020184490) using five databases from 1999 to 2019.
Methods: Studies were included if they reported primary data on lifetime costs for PWH. Two reviewers independently assessed the titles and abstracts, and data were extracted from full texts: lifetime cost, year of currency, country of currency, discount rate, time horizon, perspective, method used to estimate cost and cost items included. Descriptive statistics were used to summarize the discounted lifetime costs [2019 United States dollars (USD)].
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To assess the impact of the COVID-19 pandemic on health and HIV expenditure, UNAIDS carried out a modelling study on fiscal space for health and HIV. From a sample of 28 countries, three countries...the Democratic Republic of the Congo, Jamaica, and Lesotho—were selected to capture health and HIV expenditure impacts across countries with especially marked differences in burdens of disease (including HIV prevalence), HIV donor dependency, level of economic development, and geographic location. While the three-country sample is too small to permit findings to be generalized to other countries, these analyses are useful for informing UNAIDS’ work to identify some policy positions to minimize the COVID-19 pandemic’s impact on the HIV response.
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Background: Community health worker (CHW) programmes are a valuable component of primary care in resource-poor settings. The evidence supporting their effectiveness generally shows improvements in disease-specific outcomes relative to the absence of a CHW programme. In this study, we evaluated expan...ding an existing HIV and tuberculosis (TB) disease-specific CHW programme into a polyvalent, household-based model that subsequently included non-communicable diseases (NCDs), malnutrition and TB screening, as well as family planning and antenatal care (ANC).
Methods: We conducted a stepped-wedge cluster randomised controlled trial in Neno District, Malawi. Six clusters of approximately 20 000 residents were formed from the catchment areas of 11 healthcare facilities. The intervention roll-out was staggered every 3 months over 18 months, with CHWs receiving a 5-day foundational training for their new tasks and assigned 20–40 households for monthly (or more frequent) visits.
Findings: The intervention resulted in a decrease of approximately 20% in the rate of patients defaulting from chronic NCD care each month (−0.8 percentage points (pp) (95% credible interval: −2.5 to 0.5)) while maintaining the already low default rates for HIV patients (0.0 pp, 95% CI: −0.6 to 0.5). First trimester ANC attendance increased by approximately 30% (6.5pp (−0.3, 15.8)) and paediatric malnutrition case finding declined by 10% (−0.6 per 1000 (95% CI −2.5 to 0.8)). There were no changes in TB programme outcomes, potentially due to data challenges.
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Cervical cancer is a disease of the female reproductive tract caused primarily by oncogenic types of human papillomavirus
(HPV). In 2020, it was the fourth most common cancer among women worldwide, with an estimated 604 000 new cases and 342 000 deaths
Second Edition
AIDS Medicines and diagnostics services
July 2015
Training for Health Care Workers
An integrated approach to health and human rights lies at the heart of ensuring the dignity and well-being of women living with HIV.
Moving avidence into action
This document is part of a series of briefs for health program managers interested in implementing evidence-based programs. With a special emphasis on underutilized interventions, they present evidence on programs that work and provide guidance and resources for replicat...ion.
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