New, powerful interventions such as early treatment and pre-exposure prophylaxis are emerging as options for HIV prevention globally. However, their inclusion in HIV prevention strategies at the national level is not warranted, given health systems limitations;and stakeholders'concerns. Moreover, the ways in which such strategies could be incorporated not fixed, and strategic combination prevention programs must be designed. This proposal intends to promote, and study, a process through which (1) HIV prevention stakeholders in Peru can express their views and concerns about existing and emerging (e.g. Pre-Exposure Prophylaxis, Early Treatment for Prevention) HIV prevention interventions focused on MSM/transwomen;(2) the capacity of the health system and changes needed to incorporate emerging interventions, and associated costs, will be assessed;(3) combination prevention scenarios associated with effectiveness and cost-effectiveness estimations will be developed;and (4) stakeholders will seek to agree on one or more feasible and acceptable prevention scenarios, for potential implementation. Methods to be used include stakeholder analysis, health systems and cost assessments, mathematical modeling based on global evidence of effective interventions and on local evidence of stakeholders'views and of health systems conditions, and scenario analysis to discuss proposed scenarios and seek consensus on the most viable one(s) for future implementation.
This proposal intends to promote, and study, a process through which (1) HIV prevention stakeholders in Peru can express their views and concerns about existing and emerging (e.g. Pre-Exposure Prophylaxis, Early Treatment for Prevention) HIV prevention interventions focused on MSM/transwomen;(2) the capacity of the health system and changes needed to incorporate emerging interventions, and associated costs, will be assessed;(3) combination prevention scenarios associated with effectiveness and cost-effectiveness estimations will be developed through mathematical modeling, based on evidence gathered in previous steps;and (4) stakeholders will seek to agree on one or more feasible and acceptable prevention scenarios, for potential implementation.