Journal of acquired immune deficiency syndromes : JAIDS
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J. Acquir. Immune Defic. Syndr. · Sep 2011
Public funding of HIV/AIDS prevention, treatment, and support in California.
To determine the amount of public financing for HIV/AIDS in California and its distribution among treatment, prevention, and support services. To determine the geographical distribution of public financing for HIV/AIDS within California. ⋯ Treatment expenditures overshadow prevention spending. The dominance of entitlement programs in funding for HIV/AIDS treatment challenges policy makers to monitor the extent and quality of HIV/AIDS care in California. A unified health information system for HIV/AIDS that bridged the fragmented health payment system's data silos would benefit policy makers' efforts to monitor the delivery of HIV/AIDS services.
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J. Acquir. Immune Defic. Syndr. · Aug 2011
ReviewLeveraging the private health sector to enhance HIV service delivery in lower-income countries.
Evidence that the private health sector is a key player in delivering health services and impacting health outcomes, including those related to HIV/AIDS, underscores the need to optimize the role of the private health sector to scale up national HIV responses in lower-income countries. This article reviews findings on the types of HIV/AIDS services provided by the private health sector in developing countries and elaborates on the role of private providers of HIV services in Ethiopia. Drawing on data from the nation's innovative Private Health Sector Project, a pilot project that has demonstrated the feasibility of public-private partnerships in this area, the article highlights the potential for national governments to scale up HIV/AIDS services by leveraging private health sector resources, innovations, and expertise while working to regulate quality and cost of services. Although concerns about uneven quality and affordability of private sector health services must be addressed through regulation, policy, or other innovative approaches, we argue that the benefits of leveraging the private sector outweigh these challenges, particularly in light of finite donor and public domestic resources.
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J. Acquir. Immune Defic. Syndr. · Aug 2011
Expanding the space: inclusion of most-at-risk populations in HIV prevention, treatment, and care services.
The provision of appropriate HIV prevention, treatment, and care services for most-at-risk populations (MARP) will challenge many health care systems. For people who sell sex or inject drugs and for men who have sex with men, stigma, discrimination, and criminalization can limit access to care, inhibit service uptake, and reduce the disclosure of risks. ⋯ We discuss integrated models, stand-alone services, and hybrid models, which may be appropriate for some MARP in some settings. Both public health and human rights frameworks concur that those at greatest risk should have expanded access to services.
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J. Acquir. Immune Defic. Syndr. · Aug 2011
Game changers: why did the scale-up of HIV treatment work despite weak health systems?
Game changers are radical innovations that result in fundamental and durable changes. The global HIV program scale-up witnessed over the past decade has included some innovations that are not well appreciated. The willingness to rapidly adopt and implement innovations, the flexibility and speed of program implementation, and the readiness to re-examine professional roles are just a few of such game changers. However, moving ahead, further work is needed to enhance the quality of programs, to energetically tackle HIV prevention, to build on this success, and to address other health threats that these same communities face.