Division of HIV Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia (Drs Shrestha, Ms Galindo, Courtenay-Quirk, and Harshbarger); SeKON, Reston, Virginia (Mr Abdallah); Division of Infectious Diseases, Emory University School of Medicine, Emory Vaccine Center, and Rollins School of Public Health, Atlanta, Georgia (Dr Marconi); Atlanta VA Medical Center, Decatur, Georgia (Dr Marconi); Rutgers New Jersey Medical School, Newark, New Jersey (Drs DallaPiazza and Swaminathan); University of South Florida Morsani College of Medicine, Tampa, Florida (Dr Somboonwit); and RTI International, Research Triangle Park, North Carolina (Dr Lewis and Ms Khavjou).
J Public Health Manag Pract. 2023;29(3):326-335. doi: 10.1097/PHH.0000000000001695. Epub 2023 Mar 2.
Digital video-based behavioral interventions are effective tools for improving HIV care and treatment outcomes.
To assess the costs of the Positive Health Check (PHC) intervention delivered in HIV primary care settings.
DESIGN, SETTING, AND INTERVENTION: The PHC study was a randomized trial evaluating the effectiveness of a highly tailored, interactive video-counseling intervention delivered in 4 HIV care clinics in the United States in improving viral suppression and retention in care. Eligible patients were randomized to either the PHC intervention or the control arm. Control arm participants received standard of care (SOC), and intervention arm participants received SOC plus PHC. The intervention was delivered on computer tablets in the clinic waiting rooms. The PHC intervention improved viral suppression among male participants. A microcosting approach was used to assess the program costs, including labor hours, materials and supplies, equipment, and office overhead.
Persons with HIV infection, receiving care in participating clinics.
The primary outcome was the number of patients virally suppressed, defined as having fewer than 200 copies/mL by the end of their 12-month follow-up.
A total of 397 (range across sites [range], 95-102) participants were enrolled in the PHC intervention arm, of whom 368 participants (range, 82-98) had viral load data at baseline and were included in the viral load analyses. Of those, 210 (range, 41-63) patients were virally suppressed at the end of their 12-month follow-up visit. The overall annual program cost was $402 274 (range, $65 581-$124 629). We estimated the average program cost per patient at $1013 (range, $649-$1259) and the cost per patient virally suppressed at $1916 (range, $1041-$3040). Recruitment and outreach costs accounted for 30% of PHC program costs.
The costs of this interactive video-counseling intervention are comparable with other retention in care or reengagement interventions.
基于数字视频的行为干预是改善艾滋病毒护理和治疗效果的有效工具。
评估在艾滋病毒初级保健环境中实施的“积极健康检查”（PHC）干预措施的成本。
设计、地点和干预措施：PHC 研究是一项随机试验，评估了在美国 4 家艾滋病毒护理诊所中提供的高度定制、互动视频咨询干预措施对改善病毒抑制和提高护理保留率的效果。符合条件的患者被随机分配到 PHC 干预组或对照组。对照组参与者接受标准护理（SOC），干预组参与者接受 SOC 加 PHC。干预措施在诊所候诊室的计算机平板电脑上提供。PHC 干预措施改善了男性参与者的病毒抑制情况。采用微观成本法评估项目成本，包括劳动力小时数、材料和用品、设备和办公间接费用。
感染艾滋病毒的患者，在参与诊所接受护理。
主要结局是病毒抑制患者的数量，定义为在 12 个月随访结束时病毒载量少于 200 拷贝/ml。
共有 397 名（各参与点范围[范围]，95-102）参与者被纳入 PHC 干预组，其中 368 名（范围，82-98）参与者在基线时有病毒载量数据，并纳入病毒载量分析。其中，210 名（范围，41-63）患者在 12 个月随访结束时病毒得到抑制。总体年度项目成本为 402274 美元（范围，65581-124629 美元）。我们估计每位患者的平均项目成本为 1013 美元（范围，649-1259 美元），每位病毒得到抑制的患者的成本为 1916 美元（范围，1041-3040 美元）。招募和外联成本占 PHC 项目成本的 30%。
这种互动视频咨询干预措施的成本与其他保留护理或重新参与干预措施相当。
