Dandona Lalit, Kumar Sg Prem, Ramesh Yk, Rao M Chalapathi, Kumar A Anod, Marseille Elliot, Kahn James G, Dandona Rakhi
George Institute for International Health-India, Hyderabad, India.
AIDS. 2008 Jul;22 Suppl 1(0 1):S43-9. doi: 10.1097/01.aids.0000327622.24232.aa.
A rapid scaling up of HIV interventions in India is anticipated, but systematic information on how costs of HIV interventions change over time and programme scale is not available to inform planning.
We studied the changes in unit costs of two major interventions, voluntary counseling and testing (VCT) and sex worker programmes in the south Indian state of Andhra Pradesh between 2002-2003 and 2005-2006 fiscal years. Economic costs (from the provider perspective) and output data from 17 publicly funded VCT centers and 14 sex worker programmes were collected using standardized methods. We calculated unit costs for each programme in each period and explored possible reasons for the changes seen.
In 2005-2006, the VCT centers served 66 445 clients and the sex worker programmes served 32 550. The unit cost of providing VCT dropped over 3 years by half to Indian Rupees (INR) 147.5 (US$3.33) mainly because the number of clients doubled. There was no decrease in the average time spent counseling each client. The unit cost of providing services to sex workers increased 2.4 times over 3 years to INR 1401 (US$31.6) as a result of increases in male condom distribution, staff salaries and training, and treatment for sexually transmitted infections, all suggesting improved services.
The unit cost of these two interventions changed dramatically over a 3-year period, but in opposite directions. The current unit cost for VCT in Andhra Pradesh is much lower than the estimated global average for low-income settings. These local longitudinal cost data are useful to inform the currently planned scaling up of HIV interventions in India.
预计印度将迅速扩大艾滋病病毒干预措施，但缺乏关于艾滋病病毒干预措施成本如何随时间和项目规模变化的系统信息，无法为规划提供参考。
我们研究了印度南部安得拉邦在2002 - 2003财年至2005 - 2006财年期间，两项主要干预措施（自愿咨询检测和性工作者项目）的单位成本变化。使用标准化方法收集了17个公共资助的自愿咨询检测中心和14个性工作者项目的经济成本（从提供者角度）及产出数据。我们计算了每个时期每个项目的单位成本，并探讨了成本变化的可能原因。
在2005 - 2006年，自愿咨询检测中心服务了66445名客户，性工作者项目服务了32550名客户。提供自愿咨询检测的单位成本在3年内下降了一半，降至147.5印度卢比（3.33美元），主要原因是客户数量增加了一倍。为每位客户提供咨询的平均时间没有减少。由于男用避孕套分发、工作人员工资和培训以及性传播感染治疗费用增加，为性工作者提供服务的单位成本在3年内增加了2.4倍，达到1401印度卢比（31.6美元），所有这些都表明服务有所改善。
这两项干预措施的单位成本在3年期间发生了巨大变化，但方向相反。安得拉邦目前自愿咨询检测的单位成本远低于低收入环境下估计的全球平均水平。这些本地纵向成本数据有助于为印度目前计划扩大的艾滋病病毒干预措施提供参考。
