The Demographic Impact of HIV Medication Programs

Warren C. Sanderson, State University of New York at Stony Brook

The HIV pandemic in parts of Africa is on the verge of entering a new phase, one characterized by the increasing use of recently developed medications. In this paper, I produce a new approach to forecasting the demographic impact of these new medications, and apply it to Botswana. The model disaggregates people by age, sex, education, years since infection, and susceptibility status. The demographic impact of a medication program depends on a number of factors including the effects of the medication on reducing infectability, and on its effects on the riskiness of sexual behavior. The paper shows the sensitivity of Botswana's population to the parameters of the model. It also considers the possible offsetting effects of increases in the riskiness of sexual behavior and the effects of the medications. This analysis shows that the effects of a medication program diminish quickly over time as the number of medicated people increases.