Working paper number: 477
Author(s): Martina Mchenga, Brendan Maughan-Brown, Jane Ferguson, & Elona Toska
Unit: CSSR
Abstract:
Adolescent girls and young women (AGYW) in sub-Saharan Africa face a disproportionate risk of HIV infection, highlighting the need for targeted, cost-effective prevention strategies. This scoping review examines the economic evaluations of HIV prevention interventions for AGYW in the region, by synthesizing findings on cost-effectiveness, identifying gaps in the literature, and suggesting directions for future research. Biomedical interventions, such as oral pre-exposure prophylaxis and long-acting cabotegravir, were found to be cost-effective, particularly when integrated into public healthcare systems. Structural interventions, including school support programs and cash transfers, also demonstrated economic viability, underscoring the importance of addressing socio-economic risk factors alongside biomedical prevention interventions. However, the review identifies significant gaps, including a limited geographic scope and a scarcity of economic evaluations for structural and behavioural interventions. Most studies were undertaken in South Africa, Kenya, and Zimbabwe, thus limiting the generalizability of findings across the continent. Additionally, many evaluations focused solely on direct costs, and overlooked broader economic benefits. Future research should prioritize diverse geographic contexts, assess combination interventions, and adopt standardized outcome measures, such as quality-adjusted life years, to enhance comparability. Emphasizing affordability and scalability will be essential for practical implementation in resource-constrained settings. This review provides valuable insights for policymakers and public health practitioners seeking effective, economically sustainable HIV prevention strategies for AGYW in sub-Saharan Africa.