DEVELOPING A STATE-OF-THE-ART COMBINATION HIV PREVENTION PROGRAM FOR MSM/TRANSWOM

描述(由申请人提供)：新的、强有力的干预措施，如早期治疗和暴露前预防，正在成为全球艾滋病毒预防的选择。然而，鉴于卫生系统的局限性以及利益攸关方的关切，没有理由将其纳入国家一级的艾滋病毒预防战略。此外，纳入这些战略的方式不是固定的，必须设计战略组合预防方案。这项建议旨在促进和研究这样一个进程：(1)秘鲁的艾滋病毒预防利益攸关方可以表达他们对以男男性接触者/跨妇女为重点的现有和新出现的(如暴露前预防、早期预防治疗)艾滋病毒预防措施的看法和关切；(2)将评估卫生系统的能力和纳入新干预措施所需的变革以及相关费用；(3)将制定与有效性和成本效益估计相关的综合预防情景；以及(4)利益攸关方将寻求就一种或多种可行和可接受的预防情景达成一致，以便可能实施。将使用的方法包括利益攸关方分析、卫生系统和成本评估、基于有效干预措施的全球证据以及利益攸关方观点和卫生系统状况的当地证据的数学建模，以及情景分析，以讨论拟议的情景并就未来实施的最可行情景(S)寻求共识。

DESCRIPTION (provided by applicant): 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.