16th International AIDS Conference Toronto, Canada - August 13 - 18, 2006

LINKING MDGS AND HIV PREVENTION: UTILIZING POSITIVE EXTERNALITIES

Int Conf AIDS. 2006 Aug 13-18;16 Abstract No. ThAd0105

Stillwaggon E.
Gettysburg College, Economics, Gettysburg, United States

BACKGROUND: Global AIDS policies fail to reduce HIV or maximize return on interventions because they are isolated from other health needs. Efforts to achieve Millennium Development Goals (MDGs) are still limited by vertical strategies. Methodologies of health economics and epidemiology do not adequately incorporate demonstrated disease interactions or group-level variables. Consequently, MDG policies do not exploit those externalities to reduce costs and increase effectiveness for HIV prevention and other goals, including reducing hunger, malaria, other diseases, and maternal and child mortality.

METHODS: This research integrates policies for HIV prevention with strategies for achieving other MDGs. With biological, economic, and geographical data, it demonstrates disease synergies that promote HIV transmission and provides cost-saving ways to achieve multiple goals simultaneously.

RESULTS: Goal 1, reducing hunger, is essential for reducing HIV transmission because malnutrition reduces immune response in HIV-negative persons and increases viral load in HIV-infected persons. Malaria (Goal 6) increases viral load and transmission of HIV, both sexually and vertically. Other infectious and parasitic diseases (Goal 6) increase individual and population vulnerability to HIV transmission. Urinary schistosomiasis affects the majority of women in highly endemic areas and produces genital lesions and inflammation, indistinguishable from STDs without biopsy, and provides entry for HIV. Interventions to reduce malaria and other endemic conditions help reduce child mortality (Goal 4) and improve maternal health (Goal 5). Environmental sustainability (Goal 7), especially access to safe water and waste disposal, is necessary to achieve Goals 1, 4, 5, and 6 and also to promote school retention (Goal 2) and reduce household burdens on women and girls (Goal 3).

CONCLUSIONS: Transmission models for HIV and other diseases must incorporate multiple factors that increase risk. Achievement of MDGs requires concerted effort to recognize and exploit the numerous interactions among the goals. Overall costs of achieving MDGs are reduced by integrating programs for interrelated diseases.

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2006-08-13
ThAd0105

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