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

描述（由申请人提供）：早期治疗和暴露前预防等新的有力干预措施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，没有必要将其纳入国家一级的艾滋病毒预防战略；以及利益相关者的担忧。此外，这些战略的实施方式并不是固定的，必须设计战略组合预防方案。该提案旨在促进和研究一个过程，通过该过程(1)秘鲁的艾滋病毒预防利益相关者可以表达他们对现有和新出现的（例如暴露前预防，早期治疗预防）艾滋病毒预防干预措施的看法和关注，重点是男同性恋者/跨性别妇女；(2)将评估卫生系统的能力、纳入新出现的干预措施所需的变革以及相关费用；(3)制定与有效性和成本效益评估相关的联合预防方案；(4)利益相关者将寻求就一个或多个可行和可接受的预防方案达成一致，以备潜在的实施。将使用的方法包括利益相关者分析、卫生系统和成本评估、基于有效干预措施的全球证据和利益相关者观点和卫生系统条件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的情景寻求共识。

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.