15th International AIDS Conference Bangkok, Thailand - July 11-16, 2004

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. E10279)

Terris-Prestholt F, Foster S, Kumaranayake L, Kamali A, Kengeya-Kayondo J, Whitworth J
London School of Hygiene and Tropical Medicine, London, United Kingdom

BACKGROUND: Community-based HIV-prevention interventions focusing on information, education and communication (IEC) and strengthened treatment of sexually transmitted infections (STIs) are being widely implemented. This study presents annual costs of these two interventions implemented as part of a community trial in Masaka, Uganda (1996-1999). The study examines how costs change with project maturity and increased population uptake for communities with IEC alone and with IEC and STI implemented jointly.

METHODS: The IEC intervention consisted of video shows, dramas, distribution of educational leaflets, and community/peer-led activities. The STI intervention consisted of syndromic management training, supervision of providers, and provision of STI-drugs. Voluntary counseling and testing and condom promotion were also included. Annual economic provider's costs were collected between 1996-1999 and allocated to activities using a step-down approach. All research costs were removed. Cost per in tervention output were calculated.

RESULTS: Annual IEC activities and attendance grew from 6,988 and 54,333 in 1996 to 31,541 and 122,722, respectively, in 1999. Most activities (97-99%) were peer-led, accounting for 67-75% of attendance. Increasing intervention uptake was also observed for people treated for STIs, rising from 2,178 in 1996 to 4,001 in 1999. This is consistent with increased recognition of STI syndromes (due to IEC) and improved services providing incentives to seek treatment. The total four-year costs of IEC were $382,272 and $726,741 for IEC with STI. Although total costs grew each year, the number of IEC activities held and STIs treated rose more rapidly, leading to falling unit costs.<IMG SRC="images/prog/E10279_IMG1.jpg" border=0>

CONCLUSIONS: The large drop in annual unit costs illustrates the higher costs during the initial years of project implementation and how it takes time for communities to become fully aware of activities and services available and thus for the project to reach its optimal scale of output and minimize the unit costs of activities.

040711
E10279

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