Optimizing HIV Care in Less Developed Countries

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Principal Investigator:
Susanne Goldie, Roger Irving Lee Professor of Public Health

Department of Health Policy and Management

Dates of Research:
July 1, 2004 — June 30, 2008


Advances in the treatment of HIV disease have produced dramatic reductions in AIDS-related morbidity and mortality in the United States and Europe. However, because of severe resource constraints in Africa, Asia and less developed countries throughout the world, neither prevention of opportunistic infections nor HAART have been widely available. This project will utilize the Cost-Effectiveness of Preventing AIDS Complications (CEPAC) model to focus efforts in three less developed countries, with the following specific aims: 1) to develop a comprehensive state-transition model of the natural history and treatment of HIV disease in less developed countries; 2) to analyze data on HIV natural history, treatment efficacy, treatment cost, and quality of life in Ivory Coast, India, and South Africa; and 3) to utilize the model with country-specific data to determine the clinical impact, cost, and cost-effectiveness of different strategies for opportunistic infection prophylaxis, tuberculosis preventive therapy, and antiretroviral use in each of these countries, and to disseminate these analyses to help inform and develop country specific guidelines for HIV care. By formally addressing the resource limitations for HIV care in these representative less developed countries, this project will help elucidate questions of optimal HIV management for clinicians, public health officials, and policy makers, providing a durable tool which can be used to address questions in these countries and in other settings worldwide.