러시아ㆍ유라시아

The national HIV response in Belarus includes several priority prevention and treatment programs. Belarus continues to experience a growing epidemic, which, however, is projected to remain concentrated in key populations. People who inject drugs (PWID) continue to account for approximately 50 percent of new infections. Moreover, although transmission is shifting toward sexual transmission, even in 2030 (assuming constant program coverage and behaviors), over 33 percent of infections are projected to remain among PWID.In Belarus in the early 2000s, the HIV epidemic among men who have sex with men (MSM) was relatively small. However, according to Optima estimates, MSM have become a rapidly growing segment of the epidemic and, by 2030, are projected to account for 1 in 7 new infections according to Optima.Large proportions of HIV acquisition in the general population in Belarus likely are due indirectly to transmission in three key populations: female sexual partners of men who inject drugs, MSM, and clients of sex workers.Different optimization and scenario analyses were carried out in this allocative efficiency (AE) study. The first consistent finding of these analyses was the critical role of scaling up ART, which will substantially impact both incidence and deaths.A second consistent finding is the continued need for scaling up HIV services for people who inject drugs.A third consistent finding is that Belarus could increase the impact of its HIV program by reallocating funds to high-impact programs. It could enhance this impact by increasing the total funding available to the HIV response so that high-impact programs could be scaled up further. With optimized allocations of the same amount of funding available as in 2013 (US$19.7 million), over 2015–20, new HIV infections could be reduced by 7 percent and deaths by 25 percent. The analyses also established the optimized mix and cost of programs to achieve national targets, which for the purpose of this exercise were defined as impact targets for HIV incidence and deaths: reducing incidence by 45 percent, reducing deaths by 65 percent, and reducing MTCT to below 1 percent.However, compared to 2013 allocations, over 2015–20, the 148 percent would achieve a remarkable reduction in new infections by 43 percent and in deaths by 51 percent.