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Title: Using stated preferences to estimate the impact and cost-effectiveness of new HIV prevention products in South Africa
Author: Quaife, M.
ISNI:       0000 0004 7224 4864
Awarding Body: London School of Hygiene & Tropical Medicine
Current Institution: London School of Hygiene and Tropical Medicine (University of London)
Date of Award: 2018
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This thesis aims to deepen our understanding of the impact and cost-effectiveness of new HIV prevention products in South Africa. It explores how stated preferences for products vary across groups, and uses these data to estimate their cost-effectiveness in different populations. Also, it seeks to predict how products themselves may change the economics of sex work and lead to risk compensation among female sex workers (FSWs). The validity of predicting behaviours through the use of stated preference methods is explored through a systematic review and meta-analysis. By integrating methods from the fields of health economics and infectious disease modelling, this thesis aims to give better predictions of the potential impact and cost-effectiveness of HIV prevention products. This is a paper-style thesis which incorporates seven papers and a short correspondence publication, linked by short pieces of supporting material. The thesis finds that products offering effective multipurpose protection would be cost-effective among younger female groups and FSWs. However, it predicts that products could change the economics of sex work, potentially leading to risk compensation among FSWs. A dynamic transmission model is used to show how this risk compensation could meaningfully reduce product impact. This thesis demonstrates the value of combining economic and epidemiological modelling methods to explore preventative behaviours in HIV. Further work is needed to assess the external validity of these methods.
Supervisor: Terris-Prestholt, F. ; Vickerman, P. Sponsor: Economic and Social Research Council ; Bill and Melinda Gates Foundation ; USAID via PATH
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral