Publication:
Optimizing Investments in Georgia’s HIV Response

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Date
2016-03-01
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2016-03-01
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Abstract
Georgia has a concentrated but growing HIV epidemic. Over the past decade, HIV prevalence has increased among all population groups, particularly among men who have sex with men (MSM). If current conditions (behaviors and service coverage) are sustained up to 2030, the epidemic is expected to stabilize among female sex workers (FSWs). At the same time, HIV prevalence among people who inject drugs (PWID) and the clients of female sex workers (FSW) may increase, but at a slower rate than in the past. MSM account for the largest proportion of new infections and experience the highest prevalence levels of HIV (13 percent in 2012).1 However, prevention programs that specifically target MSM currently account for approximately only 3 percent of HIV spending.The HIV epidemic in the general population is expected to increase due largely to the increasing HIV prevalence among MSM and existing prevalence among PWID.The HIV epidemic among PWID in Georgia has stabilized due to significant and prolonged efforts to target this population.Testing key populations and their sexual partners is the most cost-effective strategy to identify those who require antiretroviral therapy (ART). Testing key populations and their sexual partners is the most cost-effective strategy to identify those who require antiretroviral therapy (ART).Opportunities exist to further optimize investments.Improvements in technical efficiency may provide additional gains.The health and economic burden of HIV in Georgia is growing.In the long term, the model predicts that HIV resource needs will increase with rising incidence and prevalence. However, the analysis estimates that optimizing current allocations by increasing spending on ART provision while sustaining investment in key populations could save approximately 224,635 dollars annually. The results also show that optimizing the allocation of current spending would lower annual spending commitments for newly infected PLHIV by approximately 15 percent. Current annual spending will not be enough to achieve National HIV Strategic Plan and international targets.
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World Bank. 2016. Optimizing Investments in Georgia’s HIV Response. © World Bank, Washington, DC. http://hdl.handle.net/10986/24966 License: CC BY 3.0 IGO.
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