Educating Sex Workers Is Best Weapon in Africa's AIDS Fight: Experts

Providing HIV awareness counseling to prostitutes in Africa is a life-saving strategy that is more than 2,000 times as cost-effective as treating AIDS patients with antiretroviral drugs, according to research presented Wednesday at the African AIDS conference in Burkina Faso.

Advising sex workers on risky practices and giving them condoms costs just $1.32 per year per life saved, according to a team from the Institute for Human Development at the University of California at Berkeley. By comparison, administering the antiretroviral drug cocktail costs about $3,800 per year per life saved. Even if generic drugs are used, the cost remains high -- $3,016 per life-year saved -- due to the expenses of administering the drugs and monitoring patients.

In making the presentation, Berkeley researcher Emiko Masaki said the figures were emphatic proof that precious dollars should be focused far more on preventing AIDS than on treating it. "Treatment and preventing are competing for the same funds," she said. "But resource allocation decisions affect the number of lives saved. Prevention should take a higher priority over treatment." Nevirapine, which helps prevent mother-to-baby HIV transmission, costs just $11 per life-year saved. Encouraging people to undergo HIV tests and providing safe sex counseling cost between $22 and $30 per life-year saved. The research is based on a comparison of seven previous studies on HIV prevention and treatment in sub-Saharan Africa, as well as the team's own estimates of drug costs.

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