ArticleThe Lancet. Public health2019
The impact and cost-effectiveness of combined HIV prevention scenarios among transgender women sex-workers in Lima, Peru: a mathematical modelling study.
Article in The Lancet. Public health, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.
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Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it, 43 citations in OpenAlex.
- Evolving landscape of economic evaluations of HIV pre-exposure prophylaxis and pre-exposure prophylaxis implementation strategies: a systematic review.Journal of the International AIDS Society · 2025Pooled it
- Costs and Cost-Effectiveness of Biomedical, Non-Surgical HIV Prevention Interventions: A Systematic Literature Review.PharmacoEconomics · 2023Pooled it
- Tenofovir to Prevent HIV Infection in Western China: Pragmatic Randomized Controlled Trial.JMIR public health and surveillance · 2025Trial
- Cost-Effectiveness of an Interdisciplinary, Internet-Based Transgender Health Care Program in Germany: Economic Evaluation Alongside a Randomized Controlled Trial.Journal of medical Internet research · 2025Trial
- Updates on HIV Pre-exposure Prophylaxis in Latin America: Available Drugs and Implementation Status.Le infezioni in medicina · 2025Review
- Pharmacoeconomic perspectives on HIV: integrating data for long-term treatment and prevention.Frontiers in medicine · 2025Review
- Enhanced Cohort Methods for HIV Research and Epidemiology (ENCORE): Protocol for a Nationwide Hybrid Cohort for Transgender Women in the United States.JMIR research protocols · 2024Article
- Social, economic, and physical side effects impact PrEP uptake and persistence among transgender women in Peru.BMC public health · 2024Article
- Including transgender populations in mathematical models for HIV treatment and prevention: current barriers and policy implications.Journal of the International AIDS Society · 2024Article
- Acceptability of venue-based HIV testing and prevention interventions for men who have sex with transgender women and transgender women in Lima, Perú: a formative, qualitative study.HIV research & clinical practice · 2024Article
- Factors associated with condomless anal sex among adolescent men who have sex with men and transgender women in three Brazilian state capitals: a PrEP1519 study.Revista de saude publica · 2024Article
- Article
- Implementation and resource needs for long-acting PrEP in low- and middle-income countries: a scoping review.Journal of the International AIDS Society · 2023Article
- Intersectional stigma and the arc of intranational migration: experiences of transgender adolescents and women who migrate within Peru.BMC public health · 2023Article
- Finding and treating early-stage HIV infections: A cost-effectiveness analysis of theLancet regional health. Americas · 2022Article
- Overlapping Key Populations and HIV Transmission in Tijuana, Mexico: A Modelling Analysis of Epidemic Drivers.AIDS and behavior · 2021Article
- Self-Identity, Beliefs, and Behavior Among Men Who Have Sex with Transgender Women: Implications for HIV Research and Interventions.Archives of sexual behavior · 2021Article
- The wisdom of mistrust: qualitative insights from transgender women who participated in PrEP research in Lima, Peru.Journal of the International AIDS Society · 2021Article
- Evolving HIV epidemics: the urgent need to refocus on populations with risk.Current opinion in HIV and AIDS · 2019Review
- The HIV epidemic in Latin America: accomplishments and challenges on treatment and prevention.Current opinion in HIV and AIDS · 2019Review
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Authors and funding
11 authors at 8 institutions in 4 countries.
Funding
Abstract
backgroundHIV incidence remains high among transgender women in Lima, Peru, most of whom report sex work. On the basis of a stakeholder analysis and health system capacity assessment, we designed a mathematical model to guide HIV programmatic planning among transgender women sex workers (TWSW) in Lima.
methodsUsing a deterministic compartmental model, we modelled HIV transmission among TWSW, their stable partners, and their clients to estimate the impact and cost-effectiveness of combinations of interventions compared with the standard of care on reducing HIV incidence over a 10-year period. We simulated HIV transmission accounting for differences in sexual positioning in anal intercourse and condom use by partner type and fitted the model to HIV surveillance data using Latin hypercube sampling. The interventions we considered were 15% relative increase in condom use with clients and 10% relative increase with stable partners; increase in antiretroviral treatment (ART) coverage at CD4 count lower than 500 cells per mm
findingsUnder the basic scenario, combining the four interventions of increasing condom use with clients and stable partners, extending ART to people with CD4 count greater than or equal to 500 cells per mm
interpretationInvestments in HIV services among TWSW in Lima would be cost-effective, even under stringent cost-effectiveness criteria when accounting for setting-specific resource constraints. Notable improvements in HIV testing rates, innovative interventions to increase condom use, and reduced PrEP costs will be key to achieving the 50% incidence reduction goal. Modelling studies incorporating stakeholders' perspectives and health system assessments can bring added value to HIV policy making.
fundingNational Institutes of Health.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.