Assessment of the population-level effectiveness of the Avahan HIV-prevention programme in South India: a preplanned, causal-pathway-based modelling analysis

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Presentation transcript:

Assessment of the population-level effectiveness of the Avahan HIV-prevention programme in South India: a preplanned, causal-pathway-based modelling analysis Michael Pickles, PhD, Marie-Claude Boily, PhD, Peter Vickerman, DPhil, Catherine M Lowndes, PhD, Prof Stephen Moses, MD, Prof James F Blanchard, MD, Kathleen N Deering, PhD, Janet Bradley, MA, Banadakoppa M Ramesh, PhD, Reynold Washington, MD, Rajatashuvra Adhikary, PhD, Mandar Mainkar, PhD, Ramesh S Paranjape, PhD, Prof Michel Alary, MD The Lancet Global Health Volume 1, Issue 5, Pages e289-e299 (November 2013) DOI: 10.1016/S2214-109X(13)70083-4 Copyright © 2013 Pickles et al. Open Access article distributed under the terms of CC BY-NC-ND Terms and Conditions

Figure 1 Proportions and total numbers of HIV infections averted over first 4 years of Avahan in each modelled IBBA district, including estimates from men who have sex with men and the general population The Bayes factor describes the strength of evidence for the effectiveness estimate in each district (strong evidence=Bayes factor >5; moderate evidence=Bayes factor >2 to 5; and weak evidence=Bayes factor ≤2). IBBA=integrated behavioural and biological assessment. *No fits to the control condom hypothesis. The Lancet Global Health 2013 1, e289-e299DOI: (10.1016/S2214-109X(13)70083-4) Copyright © 2013 Pickles et al. Open Access article distributed under the terms of CC BY-NC-ND Terms and Conditions

Figure 2 Trends in consistent condom use and HIV prevalence among female sex workers (A) Consistent condom use in districts with moderate to strong evidence. (B) HIV prevalence in districts with moderate to strong evidence. (C) Consistent condom use in districts with weak evidence. (D) HIV prevalence in districts with weak evidence. District-level estimates were weighted by the relative population size of female sex workers. Data are median values, with dark shaded areas representing 50% credibility intervals (CrIs) and light shaded areas representing 95% CrIs. The Lancet Global Health 2013 1, e289-e299DOI: (10.1016/S2214-109X(13)70083-4) Copyright © 2013 Pickles et al. Open Access article distributed under the terms of CC BY-NC-ND Terms and Conditions

Figure 3 Distribution of the number of HIV infections averted over first 4 years (A) and all 10 years (B) across all Avahan districts in southern India Districts that were not modelled are shaded with diagonal stripes. The Lancet Global Health 2013 1, e289-e299DOI: (10.1016/S2214-109X(13)70083-4) Copyright © 2013 Pickles et al. Open Access article distributed under the terms of CC BY-NC-ND Terms and Conditions