Abstract
Even in generalised epidemics, HIV is heterogeneous and comprises microepidemics in specific geographies and key populations. National programmes for HIV prevention need a framework and instruments to optimise the effect of available resources through strategic use of local epidemiological data. In this issue of The Lancet, Sarah-Jane Anderson and colleagues 1 Anderson S-J Cherutich P Kilonzo N et al. Maximising the effect of combination HIV prevention through prioritisation of the people and places in greatest need: a modelling study. Lancet. 2014; 384: 249-256 Summary Full Text Full Text PDF PubMed Scopus (172) Google Scholar conduct mathematical modelling analyses to compare HIV prevention programmes focused on city or county level epidemiology in Kenya. Their mathematical model describes the variation in behaviour, demographics, prevention programmes, and HIV epidemiology across 47 counties and three major cities in Kenya. The estimated number of new infections is concentrated in five counties that account for almost 40% of new infections in the country. Maximising the effect of combination HIV prevention through prioritisation of the people and places in greatest need: a modelling studyThe focused approach achieves greater effect than the uniform approach despite exactly the same investment. Through prioritisation of the people and locations at greatest risk of infection, and adaption of the interventions to reflect the local epidemiological context, the focused approach could substantially increase the efficiency and effectiveness of investments in HIV prevention. Full-Text PDF
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