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Copenhagen Consensus Center

Rethink HIV: Preventing Sexual Transmission Perspective, Walque

Perspective Paper

The assessment paper by Behrman and Kohler (2011) is comprehensive, clear and supported by a strong analysis. Their selection of three interventions makes sense based on the current evidence. The role of this perspective paper is, using the assessment paper as a starting point, to propose a discussion of the assessment paper findings and offer further perspectives on the topics, possibly on the basis of more recent or more tentative evidence. This perspective paper will start by stressing the need for more and better impact evaluations of HIV/AIDS prevention interventions. Next, it will argue that cost-effectiveness calculations should better integrate potential behavioral responses to prevention interventions. Further, it will discuss implications for cost-effectiveness of scaling-up interventions, especially male circumcision. It will also argue in favor of more targeted approaches. Finally, it will review three other possible solutions mentioned but not thoroughly analyzed in the assessment paper because they have been proposed and tested only recently and the evidence about their efficacy and effectiveness remains very limited: a) treatment as prevention b) preexposure chemoprophylaxis for HIV prevention and c) conditional cash transfers.

A Perspective Paper has been written by Damien de Walque, Senior Economist in the Development Research Group (Human Development and Public Services Team), World Bank discussing the research on Preventing Sexual Transmission of HIV/AIDS.