18. HIV/AIDS Prevention and Treatment

The differential effect of contraceptive delivery versus antiretroviral therapy in preventing HIV can be shown by comparing the provision of effective contraception and of nevirapine to a population of 1,000 HIV-infected women. In the absence of an intervention, approximately 150 infants would be infected with HIV during delivery (Cates 2004). If nevirapine were available, the number of infected infants would be reduced to 82 (the expected 47 percent decline). If effective contraceptive services were available, this number would be reduced to 49. If both strategies were adopted, the number of infected infants would be further reduced to 25.

The greatest difference between providing antiretroviral therapy and providing contraception is the number of infants orphaned in the future because their mothers die of HIV infection. Three models all come to this conclusion (Reynolds and others 2004; Stover and others forthcoming; Sweat and others 2004).

Source: Authors.