Cost of improved test and treat strategies in Indonesia

Hardiawan, Donny and Juwita, Mery N. and Vadra, Jorghi and Prawiranegara, Rozar and Mambea, Indra Y. and Wisaksana, Rudi and Handayani, Miasari and Subronto, Yanri W. and Kusmayanti, Nur A. and Januraga, Pande and Sukmaningrum, Evi and Nurhayati, Nurhayati and Prameswari, Helen D. and Sulaiman, Nurjannah and Siregar, Adiatma Y. M. (2023) Cost of improved test and treat strategies in Indonesia. AIDS, 37 (8). 1189- 1201. ISSN 02699370

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Abstract

Objective:To estimate and compare the cost of improved test and treat strategies in Indonesia under HIV Awal (Early) Testing and Treatment Indonesia (HATI) implementation trial in community-based and hospital-based clinics.Design:The cost and outcome i.e. CD4+ cell count and viral load (VL) at the beginning of interventions and their change overtime) analysis of Simplifying ART Initiation (SAI), Community-based Organization and community-based ART Service (CBO), Motivational Interviewing (MI), Oral Fluid-based Testing (OFT), and Short Message Service (SMS) reminder in community-based and hospital-based clinics in 2018-2019.Method:We estimated the total and unit costs per patient (under HATI implementation trial interventions) per year from societal perspective in various settings, including costs from patients' perspective for SAI and MI. We also analyzed the outcome variables (i.e. CD4+ cell count and VL at the beginning of each intervention, the change in CD4+ cell count and VL over time, and adherence rate).Result:The unit cost per patient per year of SAI and SMS were lower at the community-based clinics, and more patients visited community-based clinics. The cost per patient visit from patient perspective for SAI and MI was mostly lower than 10% of the patients' household monthly expenditure. Average CD4+ cell count was higher and average VL was lower at the start of interventions at the community-based clinics, while average CD4+ cell count and VL changes and adherence rate were similar between the two types of clinics.Conclusion:Community-based clinics hold the potential for scaling up the interventions as it costs less from societal perspective and showed better outcome improvement during the HATI implementation trial.

Item Type: Article
Additional Information: Library Dosen
Uncontrolled Keywords: cost analysis, HIV Awal (Early) Testing and Treatment Indonesia implementation trial, HIV, Indonesia, test and treat
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Divisions: Faculty of Medicine, Public Health and Nursing > Public Health and Nutrition
Depositing User: Mukhotib Mukhotib
Date Deposited: 23 Aug 2024 01:38
Last Modified: 23 Aug 2024 01:38
URI: https://ir.lib.ugm.ac.id/id/eprint/2871

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