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Conference Paper: Evaluation of the population-level impact of HIV prevention interventions in India

TitleEvaluation of the population-level impact of HIV prevention interventions in India
Authors
Issue Date2011
PublisherThe Lancet Publishing Group. The Journal's web site is located at http://www.elsevier.com/locate/lancet
Citation
The Global Health Metrics & Evaluation Conference: Controversies, Innovation, Accountability (GHME 2011), Seattle, WA., 2011. In The Lancet, 2011, v. 377 n. 9770, p. 969-970, Supplementary Webappendix p. 87 How to Cite?
AbstractBACKGROUND: Established in 1992, the National AIDS Control Programme (NACP) aims to combat HIV in India. The majority of NACP budget has been allocated to prevention activities rather than treatment. The effort to tackle HIV through preventive measures was further reinforced by the launch of the India AIDS Initiative (Avahan) in 2003, sponsored by the Bill & Melinda Gates Foundation. The effectiveness of controlling HIV via prevention has long been a subject of debate. Few studies have provided substantive evidence on this issue. The objective of this study was to examine the impact of NACP and the Avahan initiative on population level HIV prevalence in India. METHODS: We evaluated the population level impact of NACP and Avahan by examining the association between HIV prevalence trend and the intensity of intervention programmes between 2003 and 2008. Population prevalence was estimated on the basis of the national HIV sentinel surveillance data obtained annually at antenatal clinics. The intensity of interventions was estimated with the annual cumulative grants and services provided by both programmes at the district level. A mixed effects regression model was used to estimate the association between the intervention intensity and the population HIV prevalence trends, taking into account differences in the underlying epidemic trends across states. FINDINGS: In general, the preventive efforts through NACP and Avahan appeared to be associated with a decline in HIV prevalence in the general population. Specifically, in the high HIV-burden states of Andhra Pradesh and Karnataka, higher intervention intensity was associated with significant decline in HIV prevalence between 2003 and 2008. This association was less pronounced in Maharashtra and Tamil Nadu states during this period. INTERPRETATION: This study is the first to demonstrate a beneficial impact of a nationwide HIV prevention programme. The findings suggest that HIV prevention is effective in containment of the spread of HIV. It provides support for India’s strategy, which emphasises comprehensive prevention programmes for the control of HIV.
Persistent Identifierhttp://hdl.handle.net/10722/136127
ISSN
2015 Impact Factor: 44.002
2015 SCImago Journal Rankings: 14.638
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorNg, Men_US
dc.contributor.authorGakidou, Een_US
dc.contributor.authorLevin-Rector, Aen_US
dc.contributor.authorKhera, Aen_US
dc.contributor.authorMurray, CJLen_US
dc.contributor.authorDandona, Len_US
dc.date.accessioned2011-07-27T02:03:42Z-
dc.date.available2011-07-27T02:03:42Z-
dc.date.issued2011en_US
dc.identifier.citationThe Global Health Metrics & Evaluation Conference: Controversies, Innovation, Accountability (GHME 2011), Seattle, WA., 2011. In The Lancet, 2011, v. 377 n. 9770, p. 969-970, Supplementary Webappendix p. 87en_US
dc.identifier.issn0140-6736-
dc.identifier.urihttp://hdl.handle.net/10722/136127-
dc.description.abstractBACKGROUND: Established in 1992, the National AIDS Control Programme (NACP) aims to combat HIV in India. The majority of NACP budget has been allocated to prevention activities rather than treatment. The effort to tackle HIV through preventive measures was further reinforced by the launch of the India AIDS Initiative (Avahan) in 2003, sponsored by the Bill & Melinda Gates Foundation. The effectiveness of controlling HIV via prevention has long been a subject of debate. Few studies have provided substantive evidence on this issue. The objective of this study was to examine the impact of NACP and the Avahan initiative on population level HIV prevalence in India. METHODS: We evaluated the population level impact of NACP and Avahan by examining the association between HIV prevalence trend and the intensity of intervention programmes between 2003 and 2008. Population prevalence was estimated on the basis of the national HIV sentinel surveillance data obtained annually at antenatal clinics. The intensity of interventions was estimated with the annual cumulative grants and services provided by both programmes at the district level. A mixed effects regression model was used to estimate the association between the intervention intensity and the population HIV prevalence trends, taking into account differences in the underlying epidemic trends across states. FINDINGS: In general, the preventive efforts through NACP and Avahan appeared to be associated with a decline in HIV prevalence in the general population. Specifically, in the high HIV-burden states of Andhra Pradesh and Karnataka, higher intervention intensity was associated with significant decline in HIV prevalence between 2003 and 2008. This association was less pronounced in Maharashtra and Tamil Nadu states during this period. INTERPRETATION: This study is the first to demonstrate a beneficial impact of a nationwide HIV prevention programme. The findings suggest that HIV prevention is effective in containment of the spread of HIV. It provides support for India’s strategy, which emphasises comprehensive prevention programmes for the control of HIV.-
dc.languageengen_US
dc.publisherThe Lancet Publishing Group. The Journal's web site is located at http://www.elsevier.com/locate/lancet-
dc.relation.ispartofThe Lanceten_US
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.titleEvaluation of the population-level impact of HIV prevention interventions in Indiaen_US
dc.typeConference_Paperen_US
dc.identifier.emailNg, M: marieng@hku.hken_US
dc.identifier.authorityNg, M=rp01451en_US
dc.description.naturepostprint-
dc.identifier.doi10.1016/S0140-6736(11)60169-4-
dc.identifier.hkuros186487en_US
dc.identifier.volume377en_US
dc.identifier.issue9770-
dc.identifier.spageSupplementary Webappendix p. 87-
dc.identifier.epageSupplementary Webappendix p. 87-
dc.identifier.isiWOS:000288775800004-
dc.publisher.placeUnited Kingdom-

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