中国某省降低艾滋病流行危害干预项目的成本效果分析

Cost Effectiveness Analysis of Harm Reduction Interventions in a Province of china

目的:开展成本效果分析,研究美沙酮维持治疗、针具交换以及针对暗娼人群的干预对G省艾滋病流行的影响。方法:采用UNAIDS和PANCEA项目提供的标准工具收集3类干预的成本,通过文献检索了解3类干预对行为改变的效果,利用PANCEA开发的多重干预、多重流行的成本效果模型预测3类干预对G省艾滋病流行的影响。结果:2005年,在高、低流行地区,针具交换最具成本效果,每避免1例新发艾滋病感染的成本分别为892美元和1801美元;美沙酮维持治疗项目每避免1例新发感染的成本分别为2687美元和5101美元;而针对暗娼人群的干预避免1例新发感染的成本分别为3029美元和6429美元。本研究还揭示对艾滋病干预长期投入的必要性。此外,为跟踪干预效果和预测其对艾滋病流行的影响,必须重视行为学、经济学资料的收集。

Ojbective：Through CEA,the impact of methadone maintenance therapy（MMT）,needle exchange program（NEP）,and intervention among commercial sex workers（CSWS） on HIV/AIDS epidemic in a province will be studied.Methods：Standardized cost collection tool recommend by unaids and pancea was used for collecting cost data of three interventions mentioned above.Effectiveness of three interventions on behavior change was identified through literature review.Multi-intervention,multi-epidemic cost effectiveness model developed by pancea was used to project the impact of three groups of interventions on HIV epidemic in a province.Results：In 2005,NEP was the most cost effective intervention in both high and low HIV prevalence areas.The cost for every hiv averted was 892 and 1801 usd respectively.The cost for every HIV averted through mmt was 2687 and 5101 usd.The cost for every HIV averted through the interventions targeted at csws was 3029 and 6429 usd.The study has also discussed the necessity for long term investment in order to achieve sustained outcomes.Besides,it argued that better collection of behavioral and economic data is imperative for tracking and project the impacts of any intervention on HIV epidemic.