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The Global HIV Epidemics among People Who Inject Drugs (Paperback, New)
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The Global HIV Epidemics among People Who Inject Drugs (Paperback, New)
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People who inject drugs (PWID) are at higher risk for acquiring HIV
infection than the general population in many countries. Injecting
drug use is present in 148 countries including a wide array of low
and middle income countries where HIV incidence is growing in
recent years - even as it declines elsewhere. This study was
undertaken as the third of a series of three economic analyses
examining the global epidemics of HIV/AIDS in vulnerable
populations. Informed by a critical review of epidemiological
evidence and the most recent analyses of intervention efficacy,
this work modelled the costs and impact of addressing the needs of
PWID at scale in various epidemic contexts. These particular
research questions were addressed: What are the modelled epidemic
impact and costs of implementing a minimum adaptable package of
evidence-based and human rights affirming services for prevention,
treatment, and care of HIV/AIDS in PWID in globally representative
epidemic scenarios? What are the estimated returns on investment
and costs of inaction of addressing these epidemics? Taken
together, the findings indicate: Service coverage levels for ART
and key harm reduction interventions with HIV prevention benefits
are generally inadequate. Allocative decisions for HIV/AIDS should
better reflect the burden of transmission and disease. HIV
transmission dynamics can be significantly reduced by scaling up a
package of four key harm reduction interventions specific to PWID:
Needle and Syringe Programs, Medically Assisted Therapy and HIV
Counseling and Testing, as well as proportionate access in ART
scale-up. Evidence-based and effective interventions for PWID
should be funded and implemented - in the context of HIV prevention
services for the general population, such as condom promotion.
Interventions for PWID - particularly in combination with treatment
services - are cost effective or highly cost effective investment
choices across the breadth of the global epidemic. The study
presents compelling evidence for the most cost-effective approaches
to minimising the transmission and impacts of HIV in this key
population. This evidence may guide both operational design and
policy dialogue in World Bank operations.
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