# From 90-90-90 to 95-95-95 and beyond: Optimizing and targeting combination HIV prevention for Zimbabwe and Kwazulu Natal

> **NIH NIH R01** · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · 2020 · $611,348

## Abstract

ABSTRACT/SUMMARY
Published surveillance data together with mathematical modeling make it clear that UNAIDS 2030 goals (90%
reduction in HIV incidence) are not going to be met with current spending and resource allocation, as well as
UNAIDS 2020 goals (90% of infected are detected, 90% of detected are linked to care, and 90% of linked to
care are virally suppressed) are not going to be met by 2020. Existing models suggest a tripling in HIV
spending (from $12.8 billion to $40 billion per year) would be necessary to meet these goals, together with an
optimizing of that spending. Indeed, without optimization, the necessary spending for that goal would likely top
$52 billion per year.
To achieve UNAIDS 2030 goals it will be necessary to critically assess the role of all available tools and tailor
strategies to maximize their impact. However, current mathematical models omit important tools in the arsenal
for achieving 2030 goals in resource-limited regions, including: (1) Specific interventions that target the HIV
care continuum (in particular specific interventions with randomized controlled-trial evidence include SMS-
based text reminders for appointments and/or medications and combination interventions similar to
Link4Health [including accelerated medication initiation, SMS-based text reminders, care/information package
+/- noncash financial incentive]), (2) targeting interventions to high risk populations (such as those with alcohol
use disorders [AUDs] and common mental disorders [CMDs]) that are specifically relevant to a region’s
demographics and policy constraints, and (3) alternate timing of the peak of HIV spending (earlier is better
because it leads to “getting ahead of the epidemic” but may be less feasible). Accordingly, our proposal
incorporates these tools into a mathematical model to evaluate the allocative efficiency of a wide spectrum of
combination HIV prevention strategies focusing on the countries of Zimbabwe and South Africa because of
their disproportionate burden of HIV morbidity and mortality.

## Key facts

- **NIH application ID:** 10018459
- **Project number:** 5R01AA027976-02
- **Recipient organization:** NEW YORK UNIVERSITY SCHOOL OF MEDICINE
- **Principal Investigator:** Ronald Scott Braithwaite
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $611,348
- **Award type:** 5
- **Project period:** 2019-09-20 → 2024-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10018459

## Citation

> US National Institutes of Health, RePORTER application 10018459, From 90-90-90 to 95-95-95 and beyond: Optimizing and targeting combination HIV prevention for Zimbabwe and Kwazulu Natal (5R01AA027976-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10018459. Licensed CC0.

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