Costs and outcomes of HIV PrEP provision in a routine setting – South Africa

Over the past five years much of the prevention literature has focused on treatment as prevention, but more recently there have been renewed calls to refocus on prevention, as treatment alone may not bring the epidemic under control in a reasonable time frame. Combination HIV prevention strategies now include effective biomedical interventions, including PrEP. PrEP is one of the five UNAIDS pillars of HIV prevention and was recently recommended by the WHO for those at “substantial risk” of HIV infection. In December 2016 the SAG released guidelines expanding combination prevention and treatment to include PrEP. South Africa is currently targeting PrEP to three populations – sex workers, MSM, and adolescent girls and young women (AGYW) – through a phased roll out at designated pilot sites.  Large scale national rollout is dependent on having sufficient resources.  While modelled estimates provide useful approximations, the most accurate cost estimates are based on actual patient resource usage in routine implementation.  This cost data when combined with outcome data may also help identify efficient delivery models if there are suitable comparisons.

The objectives of this study are to estimate the average cost and associated outcomes of PrEP provision in a routine setting in South Africa, stratified by key population.

Publications and other documents

Van Vliet MM, Hendrickson C, Nichols BE, et al. Epidemiological impact and cost‐effectiveness of providing long‐acting pre‐exposure prophylaxis to injectable contraceptive users for HIV prevention in South Africa: a modelling study. J Int AIDS Soc 2019; 22:e25427.

Hendrickson C, Long L, van de Vijver DA, et al. Novel metric for evaluating pre-exposure prophylaxis programme effectiveness in real-world settings. Lancet HIV 2020; https://doi.org/10.1016/S2352-3018(19)30344-3.