Effectiveness and Efficiency of Improving HIV Service Provision for Key Populations in Nicaragua

HIV in Nicaragua is concentrated among key populations – men who have sex with men, female sex workers, and female transgender – in whom prevalence is 600–4,000 times higher than the general population. The United States Agency for International Development (USAID) PrevenSida project is aimed at increasing healthy behavior among key populations and people with HIV and improving testing, counseling, and continuity of prevention and treatment by building capacity and improving performance of non-governmental organizations (NGOs) providing services to key populations.

URC's own Edward Broughton, Oscar Nunez, Rafael Arana, and Alexey Oviedo published an original research article for Frontiers in Public Health evaluating individuals in key populations covered by NGOs receiving assistance from PrevenSida from 2012 to 2014. 

By 2014, PrevenSida had distributed about $600,000 in grants and used $230,000 to support 24 NGOs serving 72,955 people in high-risk populations in Nicaragua. Comparing PrevenSida’s intervention to business-as-usual, we evaluated the cost-effectiveness of the program.

The evaluation found that PrevenSida’s efforts to prevent HIV infection cost around $12 per person on average, with regional variability. The estimated incremental cost-effectiveness ratio was $50,700 per HIV case averted or $2,600 per Disability-adjusted Life Year (DALY) averted, considered highly cost-effective by WHO criteria.

Based on the findings, we argue that focused interventions for HIV service provision to key populations can be acceptably efficient in this setting.

Visit the Frontiers in Public Health website to read the full article. 

In Nicaragua, Oscar Nunez (right) and colleagues support the PrevenSida project (2015)
In Nicaragua, Oscar Nunez (right) and colleagues support the PrevenSida project (2015)
November 23, 2016
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