title: Pattern, Determinants, and Impact of HIV Spending on Care and Treatment in 38 High-Burden Low- and Middle-Income Countries.
abstract: : Achieving the 90-90-90 targets by 2020 requires increased focus, resources, and efficiency to provide earlier access to antiretroviral therapy (ART).
  
  
  METHODS
  We used 2009 to 2013 National AIDS Spending Assessment data to assess HIV care and treatment spending in 38 high-burden, low- and middle-income countries (LMICs).
  
  
  RESULTS
  In 2013, 23 of the 38 high-burden countries spent less than 50% of total HIV spending on care and treatment. HIV spending on ART per people living with HIV (PLHIV; adjusted) averaged US$299 (US$32-US$2463). During 2009 to 2013, a 10% increase in average spending on care and treatment per PLHIV was associated with an increase in ART coverage of 2.4% and a decrease in estimated AIDS-related death rate of 2.4 per 1000 PLHIV.
  
  
  CONCLUSIONS
  HIV spending in high-burden LMICs does not consistently reflect the new science around the preventative and clinical benefits of earlier HIV diagnosis and ART initiation.
authors.affiliation: International Association of Providers of AIDS Care, Washington DC, USA rgranich@iapac.org.
authors.forename: Reuben
authors.initials: R
authors.lastname: Granich
authors.affiliation: International Association of Providers of AIDS Care, Washington DC, USA.
authors.forename: Somya
authors.initials: S
authors.lastname: Gupta
authors.affiliation: British Columbia Centre for HIV/AIDS Excellence, Vancouver, British Columbia, Canada.
authors.forename: Julio
authors.initials: J
authors.lastname: Montaner
authors.affiliation: South African Centre for Epidemiological Modelling and Analysis (SACEMA), Stellenbosch, South Africa.
authors.forename: Brian
authors.initials: B
authors.lastname: Williams
authors.affiliation: International Association of Providers of AIDS Care, Washington DC, USA.
authors.forename: José M
authors.initials: JM
authors.lastname: Zuniga
mesh_terms: D019380:Anti-HIV Agents / Q000191:economics* / Q000627:therapeutic use; D003906:Developing Countries / Q000191:economics; D015658:HIV Infections / Q000188:drug therapy / Q000191:economics*; D006801:Humans; D007182:Income; D011203:Poverty; D013019:South Africa
chemical_list: D019380:Anti-HIV Agents
keywords: AIDS; HIV; antiretroviral therapy; financing