Tailoring the Local HIV Response to Local HIV Epidemic

Geographic targeting and hotspot mapping assist in identifying both geographic areas of elevated transmission and high-risk groups. The global burden of HIV/AIDS is heaviest in Sub-Saharan Africa, where 24.7 million people live with the disease and 1.5 million new infections occur each year. At higher risk for infection are female sex workers, men who have sex with men, and injecting drug users. Effective interventions for concentrated epidemics share six core components: (1) behavior-change communication, (2) condom programs and needle/syringe programs, (3) sexual health and hard-reduction services, (4) HIV testing and counseling plus ART treatment, (5) community empowerment, and (6) supportive local and national legal and policy environments. Tailoring responses to target the right people and using hotspot mapping to determine geographic focus allow for optimal allocation of national resources enabling larger investments in ART for all populations and in HIV programs for key populations. The use of Optima—an epidemic- and cost-modeling software—can facilitate this effort.