The issue
Oral pre-exposure prophylaxis (PrEP) is now considered part of the U. S. President’s Emergency Plan for AIDS Relief HIV prevention toolkit. Prior modeling work has demonstrated that oral PrEP is most cost-effective when targeted to populations at very high risk of infection, with risk dependent on a combination of individual behavior and epidemic contexts.

Our approach
Project SOAR is first working with country stakeholders to identify specific modeling questions that would be helpful to advance PrEP policy and implementation planning and discussions in-country. Potential questions to be explored through modeling include: Given the local cost for treatment, at what level of HIV incidence does PrEP become cost-effective? What population groups (based on risk behavior, age, and/or location) is HIV incidence sufficiently high for PrEP to be cost-effective? How is this projected to change as other interventions are scaled up? Providing oral PrEP to which groups could substantially contribute to HIV epidemic control at a national level? What would be the total program cost of scaling up oral PrEP to specific populations, given assumptions or data about PrEP unit cost, subpopulation size, and uptake? What are the potential cost savings of delivering PrEP in terms of lower antiretroviral treatment costs? SOAR will then design, adapt, or apply existing modeling tools to estimate the expected cost-effectiveness and impact of oral PrEP within the larger portfolio of HIV prevention interventions.

The impact
SOAR, in consultation with the USAID Missions, will present these analytical findings in-country and discuss implications for PrEP strategy and planning.