Model Inputs
Variable | All Regions |
---|---|
Increase in HIV acquisition with POI use28 | 40% |
Average maternal age at time of birth | 25 years |
Reduction in life expectancy for women with HIV on ART38 | 25% |
Reduction in life expectancy for women with HIV not on ART38 | 75% |
Probability of maternal-to-child transmission of HIV if ARVs used in labor40 | 2% |
Probability of maternal-to-child transmission of HIV if ARVs not used in labor40 | 25% |
Standard discount ratea,39 | 3% |
Regional Inputs | |||||||||
---|---|---|---|---|---|---|---|---|---|
Central Africa | Eastern Africa | Southern Africa | Western Africa | ||||||
Chad | DRC | Kenya | Tanzania | Uganda | Malawi | South Africa | Burkina Faso | Senegal | |
Life expectancy (years)41 | 51.5 | 58.7 | 61.6 | 65.0 | 58.5 | 62.7 | 57.2 | 58.2 | 66.4 |
HIV36 | |||||||||
HIV incidence | .001 | .0003 | .003 | .002 | .005 | .004 | .015 | .0005 | .0001 |
Probability of ARVs in labor | .46 | .67 | .74 | .86 | .97 | .79 | .99 | .89 | .36 |
Probability of accessing ARVs | .36 | .33 | .59 | .57 | .57 | .61 | .48 | .54 | .40 |
Contraceptive use8,9 | |||||||||
POIs | .09 | .012 | .14 | .087 | .14 | .32 | .28 | .061 | .052 |
COCs | .005 | .007 | .07 | .06 | .03 | .02 | .05 | .02 | .041 |
Implant | .00 | .007 | .016 | .005 | .025 | .09 | .00 | .08 | .012 |
IUD | .00 | .002 | .023 | .002 | .005 | .01 | .01 | .001 | .006 |
Sterilization | .001 | .007 | .041 | .041 | .027 | .10 | .14 | .002 | .002 |
Unmet need for contraceptionb,8 | .22 | .28 | .29 | .26 | .35 | .38 | .13 | .25 | .31 |
Maternal mortality6 | |||||||||
Live birthc | 856 | 693 | 510 | 546d | 343 | 634 | 138 | 371 | 315 |
Unsafe abortiond,e | 80 | 80 | 100 | 100 | 100 | 40 | 40 | 80 | 80 |
Pregnancy outcomes (per 100 women)13 | |||||||||
Live birth | .77 | .77 | .76 | .76 | .76 | .66 | .66 | .78 | .78 |
Induced abortion | .13 | .13 | .14 | .14 | .14 | .24 | .24 | .12 | .12 |
Spontaneous abortion | .09 | .09 | .09 | .09 | .09 | .09 | .09 | .09 | .09 |
Ectopic pregnancy | .01 | .01 | .01 | .01 | .01 | .01 | .01 | .01 | .01 |
Abbreviations: ART, antiretroviral therapy; ARVs, antiretrovirals; COC, combined oral contraceptive; DRC, Democratic Republic of the Congo; IUD, intrauterine device; POI, progestin-only injectable.
↵a The standard discount rate is routinely used in decision analysis to account for the fact that goods (dollars, health) are not as valuable in the future as they are in the present. Anywhere between 1.5% and 5% is considered a reasonable rate to discount health outcomes.37
↵b The number of women of reproductive age who are married or living with a partner who are fecund, are not using contraception, and report that they do not want any more children or wish to delay their next pregnancy, divided by the number of women of reproductive age who are married or living with a partner.
↵c 2015 WHO estimates of maternal mortality ratio (per 100,000 live births).
↵d Country-level data were not available and so regional estimates were used.
↵e 2008 WHO unsafe abortion rates (per 1,000 women ages 15–44 years).