A Cost Effectiveness Analysis of Increasing Human and Financial Resources for a Large PEPFAR Key Population HIV Program in Northeast Nigeria

Globally, Sub-Saharan Africa has the highest HIV burden. Although progress has been made towards achieving HIV epidemic control in this region, the progress has been uneven with minority HIV groups i.e., key populations (KPs), bearing a disproportionate burden of the epidemic. These micro-HIV epidemics will impact control gains if strategies are not implemented to prevent this. The aim of this study is to demonstrate the cost effectiveness of increasing human and financial resources for a key populations program. We utilized program level data covering a six-month period; a pre-intervention period (pre-surge) and intervention period (surge) and increased human and financial resources in line with an increased program target. The number of human resources (peer navigators) received a 3.4-fold increase, and the financial resources (budget) received a 2.5-fold increase in the surge period. We found that the number of KPs reached through our HIV services increased, and that for every $1000 spent during the surge period, 200 KPs were reached, 140 were of them we provided with HIV testing services and 16 new HIV-positive cases whereas for every $1000 spent during the pre-surge period, 71 KPs were reached, 25 of them were provided with HIV testing services and 3 new HIV-positive cases were identified. Significant funding investments, both at international and national levels is required in addition to existing prevention and treatment strategies to effectively mobilize and allocate resources for HIV/AIDS programs in order to successfully achieve epidemic control.