HIV Prevention Interventions for Sex Workers: Modeling the Impacts 183
sive HIV prevention is increased to 40, 70, and 100% among the female sex work population. When ART coverage does not increase among the adult population, the number of new infections in Brazil will increase (Status quo). With coverage of the community empowerment-based, comprehensive HIV prevention that reaches 70% among sex workers, however, a total of 4,700 new infections among the adult population may be averted between 2012 and 2016 (a 2.9% reduction). Even greater impact is observed when coverage reaches 100% and more than 7,000 new infections may be averted during this time period. Brazil: Population-wide ART scale-up and combination with the community empowerment-based, comprehensive HIV prevention for female sex workers
Table 4.4 displays the scenarios used to model the scale-up of ART among adults and the combination of ART and the community empowerment-based, comprehensive HIV prevention for female sex workers in Brazil. Table 4.4 ARTa Modeling Scenarios Scenario Brazil Status quo
Scenario 1:
Scenario 2:
ART held constant among total population (2011–16)
45%
Baseline coverage of community empowerment-based, comprehensive HIV prevention held constant among female sex workers
10.0%
Scale-up in coverage of ART by 2016 according to country estimations
270,000
Baseline coverage of community empowerment-based, comprehensive HIV prevention held constant among female sex workers
10.0%
Scale-up in coverage of ART by 2016 according to country estimations
270,000
Interpolated scale-up of community empowerment-based, comprehensive HIV prevention coverage from 2011 of additional 60% by 2016
70.0%
Source: Authors. Note: ART = antiretroviral therapy. a. Baseline ART and scale-up among adults based on county UNAIDS projections estimate, absolute numbers.
Figure 4.9 (Table 4.B.4) present the number of new HIV infections and trends of these infections among female sex workers in Brazil when ART is expanded among eligible adults, according to national estimates, by 2016.