Economic evaluation of short message service intervention for HIV prevention among men who have sex with men in China: a modelling study.

Autor: Fan RQ; Department of Infectious Diseases, Affiliated Hospital of Nantong University, Medical School of Nantong University, Nantong, JS, China., Shu JT; Department of Epidemiology and Biostatistics, School of Public Health of Nantong University, Nantong, JS, China., Huang H; Zhangjiagang Center for Disease Control and Prevention, Suzhou, JS, China., Shi LY; Department of Infectious Diseases, Affiliated Hospital of Nantong University, Medical School of Nantong University, Nantong, JS, China., Ge QW; Department of Epidemiology and Biostatistics, School of Public Health of Nantong University, Nantong, JS, China., Zhuang X; Department of Epidemiology and Biostatistics, School of Public Health of Nantong University, Nantong, JS, China. xzhuang@ntu.edu.cn., Zou MY; Department of Infectious Diseases, Nantong Third People's Hospital, Nantong University, Nantong, JS, China. zoumeiyin@126.com., Qin G; Department of Infectious Diseases, Affiliated Hospital of Nantong University, Medical School of Nantong University, Nantong, JS, China. tonygqin@ntu.edu.cn.; Department of Epidemiology and Biostatistics, School of Public Health of Nantong University, Nantong, JS, China. tonygqin@ntu.edu.cn.
Jazyk: angličtina
Zdroj: BMC public health [BMC Public Health] 2024 Dec 20; Vol. 24 (1), pp. 3553. Date of Electronic Publication: 2024 Dec 20.
DOI: 10.1186/s12889-024-20857-3
Abstrakt: Background: Men who have sex with men (MSM) globally face a high risk of HIV infection. Previous studies indicate that customized short message service (SMS) interventions could reduce high-risk behaviors that associated with HIV transmission. This study aims to evaluate the health and economic impacts of such interventions among MSM in China.
Methods: A decision tree-Markov model was developed for a simulated cohort of 100,000 MSM of 20 years old. We assessed three intervention strategies: (1) routine strategy with standard health information; (2) SMS strategy with customized messages based on individual high-risk behaviors, with 50.1% efficacy and 50% coverage; (3) LEN-LA (lenacapavir long-acting) strategy as pre-exposure prophylaxis (PrEP), with 100% efficacy lasting for 0.5-year and 50% coverage. The study period was 45 years. Primary outcomes included the number of HIV infections and HIV-related deaths. The cost-effectiveness, cost-utility and cost-benefit analyses were conducted along with sensitivity analyses from the healthcare sector perspective.
Results: The SMS strategy was more effective, averting 6,191 (22.0%) HIV infections and 2,100 (38.5%) HIV-related deaths when compared with routine strategy. The average cost-effectiveness ratios (ACERs) were US$6,361 (95% CI: 5,959-6,613) per HIV infection averted and US$18,752 (95% CI: 17,274 - 20,530) per HIV-related death averted. It had incremental cost-effectiveness ratios (ICERs) of US$1,743 (95% CI: 1,673-1,799) per QALY, with a benefit cost ratio (BCR) of 1.98 (95% CI: 1.94-2.02), compared with routine strategy. While the LEN-LA strategy may be the most effective, its high cost, coupled with the highest ICER, currently presents a considerable obstacle to its widespread adoption. The ICERs were most affected by the probability of HIV infection, intervention cost and coverage.
Conclusions: SMS strategy for preventing HIV among MSM in China is cost-effective and could be a promising strategy for HIV prevention. These findings may have implications for public health policy and resource allocation in HIV prevention efforts targeting high-risk populations.
Competing Interests: Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: Gang Qin is an editorial board member of BMC Public Health. The remaining authors declare no competing interests.
(© 2024. The Author(s).)
Databáze: MEDLINE
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