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