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在越南,针对艾滋病毒感染者中频繁饮酒者实施简短干预措施的适应和实施的成本效益。

The Cost-Effectiveness of Adapting and Implementing a Brief Intervention to Target Frequent Alcohol Use Among Persons with HIV in Vietnam.

机构信息

Department of Health Behavior, University of North Carolina at Chapel Hill Gillings School of Global Public Health, 135 Dauer Drive, CB #7420, Chapel Hill, NC, 27599-7420, USA.

University of North Carolina Project Vietnam, Hanoi, Vietnam.

出版信息

AIDS Behav. 2021 Jul;25(7):2108-2119. doi: 10.1007/s10461-020-03139-y. Epub 2021 Jan 3.

Abstract

Brief interventions to reduce frequent alcohol use among persons with HIV (PWH) are evidence-based, but resource-constrained settings must contend with competition for health resources. We evaluated the cost-effectiveness of two intervention arms compared to the standard of care (SOC) in a three-arm randomized control trial targeting frequent alcohol use in PWH through increasing the percent days abstinent from alcohol and viral suppression. We estimated incremental cost per quality-adjusted life year (QALY) gained from a modified societal perspective and a 1-year time horizon using a Markov model of health outcomes. The two-session brief intervention (BI), relative to the six-session combined intervention (CoI), was more effective and less costly; the estimated incremental cost-effectiveness of the BI relative to the SOC, was $525 per QALY gained. The BI may be cost-effective for the HIV treatment setting; the health utility gained from viral suppression requires further exploration.

摘要

针对 HIV 感染者(PWH)频繁饮酒问题的简短干预措施具有循证医学证据,但资源有限的环境必须应对卫生资源竞争的问题。我们通过提高酒精戒断天数和病毒抑制率,在一项针对 PWH 频繁饮酒问题的三臂随机对照试验中,评估了两种干预措施与标准治疗(SOC)相比的成本效益。我们从改良的社会视角和 1 年时间范围,使用健康结果的马尔可夫模型,估计了每获得一个质量调整生命年(QALY)的增量成本。与六节联合干预(CoI)相比,双节简短干预(BI)更有效且成本更低;BI 相对于 SOC 的增量成本效益为每获得一个 QALY 增加 525 美元。BI 可能对 HIV 治疗环境具有成本效益;病毒抑制带来的健康效用尚需进一步探索。

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