Grant: Knowledge Synthesis Grant

HIV is the infection that causes AIDS. HIV can be passed from mothers to their babies, so that infants are born with the disease. Very effective interventions to block mother-to-child transmission (MTCT) of HIV are now available in Canada and other high-income countries. The birth of children with HIV in wealthy countries is now very rare. However, globally, the epidemic in children is still growing. UNAIDS estimates that 2 million children were living with HIV/AIDS and an additional 340 000 became infected in 2007. The United Nations set a goal to halve HIV infections in children and to provide services to prevent MTCT to 80% of those in need by 2010. Canada contributes to fighting the global HIV/AIDS epidemic in many ways. This grant builds on a previous Canadian collaboration to develop a mathematical model to better understand the epidemic and select the best approaches to combat it. A limitation of the model is that it focuses on adults and does not yet assess strategies to prevent HIV infection in children. In partnership with the World Health Organization, we will review the best evidence on the costs and benefits of different approaches to prevent HIV MTCT in low- and middle-income countries. We will use this review to design a new module for the mathematical model to evaluate the costs and benefits of strategies to prevent HIV MTCT. We will then test the model in a specific context (Guatemala), where CIHR has previously funded work in HIV MTCT. Guatemalan decision makers wish to have information on the costs and benefits of HIV MTCT and other interventions to improve the health of mothers and children. We will work with decision-makers to generate this information and help them to acquire training in synthesis and cost-effectiveness methods. Once the tools exist, other countries can also use them. This project will secure a unique Canadian contribution to the global HIV epidemic and help countries worldwide design policies to prevent HIV in children.