HIV Prevention: To Package or Not to Package

Till Barnighausen, Harvard School of Public Health
Salal Humair, Harvard School of Public Health

One proposal to improve the effectiveness of HIV prevention that has been advocated forcefully is "prevention packages", i.e. the combination of several prevention interventions either at the population level or at the individual level. But the effectiveness of prevention packages compared to individual prevention interventions is not well-understood. We construct a novel mathematical model, accounting for feedback effects of HIV prevalence on HIV incidence, and of ART coverage on HIV incidence and mortality. We assess prevention impact on HIV incidence, HIV prevalence, antiretroviral treatment coverage, and mortality. We report findings regarding (1) the effectiveness of different HIV prevention packages in comparison to the effectiveness of individual interventions, (2) the effectiveness of prevention interventions implemented separately in a population in comparison to the effectiveness of the joint delivery of several different prevention interventions to the same individual, and (3) the effects of interaction between HIV prevention and antiretroviral treatment.