Cost-effectiveness of Scaling Up Voluntary Counselling and Testing in West-Java, Indonesia
Abstract: to evaluate the
costs-effectiveness of scaling up community-based VCT in West-Java. Methods:
the Asian epidemic model (AEM) and resource needs model (RNM) were used to
calculate incremental costs per HIV infection averted and per
disability-adjusted life years saved (DALYs). Locally monitored demographic,
epidemiological behavior and cost data were used as model input. Results:
scaling up community-based VCT in West-Java will reduce the overall population
prevalence by 36% in 2030 and costs US$248 per HIV infection averted and
US$9.17 per DALY saved. Cost-effectiveness estimation were most sensitive to the
impact of VCT on condom use and to the population size of clients of female sex
workers (FSWs), but were overall robust. The total costs for scaling up
community-based VCT range between US$1.3 and 3.8 million per year and require
the number of VCT integrated clinics at public community health centers to
increase from 73 in 2010 to 594 in 2030. Conclusion: scaling up community-based
VCT seems both an effective and cost-effective intervention. However, in order
to prioritize VCT in HIV/AIDS control in West-Java, issues of budget
availability and organizational capacity should be addressed.
Key words: HIV infections, voluntary counselling and testing,
cost-effectiveness analysis, decision maker
Author: Noor Tromp, Adiatma
Siregar, Barnabas Leuwol, Dindin Komarudin, Andre van der Ven, Reinout van
Crevel4, Rob Baltussen
Journal Code: jpkedokterangg130277
