Beeharry, GirindreSchwab, NicoleAkhavan, DariushHernández, RosalindaParedes, Carla2013-05-302013-05-302002-061-932126-67-8https://hdl.handle.net/10986/13689This paper presents a model that policymakers can use to determine the resource allocation that will prevent the maximum number of new HIV infections at any given budget level. The optimal allocation exercise was conducted in Honduras, where the epidemic is still concentrated in high-risk groups but has begun spreading into the general population. Most transmissions occur through heterosexual sex, followed by sex between men, and mother-to-child transmission. Adult prevalence is estimated at 1.4 percent. The optimization exercise involves several steps:(a) choosing population subgroups targeted for intervention; (b) estimating the proportion of each subgroup that can be reached; (c) estimating the total number of new infections expected in each subpopulation; (d) defining the set of HIV prevention interventions to be considered; (e) estimating the unit cost of each intervention; and (f) estimating the expected effectiveness of each intervention. Most of the data required to run the model has to be guesstimated or derived from the literature. To address this challenge, a group of some forty local and international experts in HIV/AIDS met in Tegucigalpa in May 2002 and arrived at the consensus estimates used in this exercise. They based their estimates on data submitted by two local epidemiologists who had conducted an extensive literature search prior to the workshop. The results from this collective exercise show that for limited HIV prevention budgets (below $500,000), condom social marketing and condom distribution prevent the maximum number of HIV infections. If the HIV prevention budget is between $750,000 and $2.5 million, then Information Education and Communication (IEC) targeted at high risk groups, HIV counseling and access to rapid testing, and an information, education and communications strategy (IEC) for the Garifunas should also be part of the country's prevention strategy. The exercise shows that some prevention interventions are unattractive even when the HIV prevention budget increases to $10 million..en-USCC BY 3.0 IGODISEASE PREVENTION & CONTROLDISEASE TRANSMISSIONEPIDEMIC DISEASESAIDS INFECTIONSAIDS INTERVENTIONSAIDS PREVENTIONHIV EDUCATIONHIV INFECTION RATESHIV PREVENTION INTERVENTIONSHIV TESTINGALLOCATION ISSUESEPIDEMIOLOGICAL DATAEPIDEMIOLOGICAL INFORMATIONEPIDEMIOLOGICAL SURVEILLANCEEPIDEMIOLOGICAL TRENDSEPIDEMIOLOGISTSHIGH RISK SEXUAL BEHAVIORMOTHER CHILD TRANSMISSIONMALE HOMOSEXUALITYHETEROSEXUALITYOUTREACH ACTIVITIESOUTREACH SERVICESDISEASE SURVEILLANCEINTERVENTION STRATEGIESHEALTH COUNSELINGTESTINGINFORMATION DISSEMINATION ACCOUNTACQUIRED IMMUNE DEFICIENCY SYNDROMEADOLESCENTSADULT PREVALENCEADULT PREVALENCE RATEAIDS CASESAIDS ECONOMICSAIDS EPIDEMICAIDS INCIDENCEANTIRETROVIRAL DRUGSBEHAVIOR CHANGEBLOOD SAFETYCHILDBEARINGCOMMERCIAL SEXCOMMERCIAL SEX WORKERCOMMERCIAL SEX WORKERSCONDOM DISTRIBUTIONCONDOM USECONSISTENT CONDOM USEDISABILITYDRUGSEFFECTIVE PREVENTIONEPIDEMIOLOGICAL SURVEILLANCEHEALTHHEALTH CAREHEALTH EXPENDITUREHETEROSEXUAL CONTACTHETEROSEXUAL SEXHETEROSEXUAL TRANSMISSIONHIGH RISK GROUPSHIGH- RISKHIGH- RISK GROUPSHIGH-RISKHIGH-RISK GROUPSHIVHIV INFECTIONSHIV PREVALENCEHIV PREVENTIONHIV PREVENTION INTERVENTIONSHIV TESTINGHIV TRANSMISSIONHOSPITALIZATIONHUMAN IMMUNODEFICIENCY VIRUSIMMUNE DEFICIENCYIMMUNODEFICIENCYINFECTIOUS DISEASESINJURIESINTERVENTIONINTRAVENOUS DRUG USERSMALARIAMANAGERSMODE OF TRANSMISSIONMORTALITYMORTALITY RATEMOTHER-CHILD TRANSMISSIONMOTHER-TO-CHILDMOTHER-TO-CHILD TRANSMISSIONNEW INFECTIONSNUTRITIONNUTRITIONOPPORTUNISTIC INFECTIONSORPHANSPATIENTSPREVENTION AND CAREPREVENTION EFFORTSPREVENTION STRATEGIESPRIVATE SECTORPUBLIC HEALTHPUBLIC SECTORRELIGIOUS BODIESRISK BEHAVIORRISK OF HIV TRANSMISSIONSEX WITH MENSEXUAL ENCOUNTERSSEXUAL ORIENTATIONSOCIAL MARKETINGSOCIAL VALUESSTDSSTISTREATMENT AND CAREUNAIDSVIOLENCEWOMEN OF CHILDBEARING AGEWORKPLACEWorld Bank10.1596/1-932126-67-8