HIV Prevention Interventions for Sex Workers: Modeling the Impacts 203
is augmented with the addition of the community empowerment-based, comprehensive HIV prevention, which may bring the prevalence down to 14% in 2016. In this case, the fact that ART saves lives, may prevent the prevalence from declining further within this five year timeframe. Figure 4.28 ART Expansion among the Adult Population and Combination with Community Empowerment-based, Comprehensive HIV Prevention for Sex Workers in Ukraine: Trends in HIV Prevalence (%) among Female Sex Workers, 2011–16
HIV prevalence (percent)
18 16
Status quo (5%)
14
ART scale-up
12
ART scale-up + Emp. scale-up (65%)
10 8 2011
2012
2013
Year
2014
2015
2016
Source: Authors. Note: Emp. = empowerment; ART = antiretroviral therapy.
Figure 4.29 (Table 4.B.24) presents the number and trends of new HIV infections among the adult population in Ukraine, between 2011 to 2016, when ART is expanded among eligible adults, according to national estimates. An additional scenario depicts the impact when the expansion of ART is combined with expanded coverage of the community empowerment-based, comprehensive HIV prevention, expands from 5% to 65% coverage of the female sex worker population by 2016. Among adults, a total of 15,900 new infections are averted between 2012 and 2016 when ART expands, compared to the status quo. This represents a 6% reduction in new infections among the adult population, between 2012–2016. With the addition of the community empowerment-based, comprehensive HIV prevention, a total of 22,300 new infections are averted, resulting in almost a 9% reduction in new infections between 2012 and 2016. Thus, the expansion of the community empowermentbased, comprehensive HIV prevention averts an additional 6,400 infections among adults, in addition to those averted by ART.