The cost-effectiveness of a resilience-based psychosocial intervention for HIV prevention among MSM in India.
AIDS
; 36(9): 1223-1232, 2022 07 15.
Article
en En
| MEDLINE
| ID: mdl-35471644
ABSTRACT
OBJECTIVE:
MSM in India are at a high risk for HIV infection given psychosocial challenges, sexual orientation stress, and stigma. We examined the cost-effectiveness of a novel resilience-based psychosocial intervention for MSM in India.DESIGN:
We parameterized a validated microsimulation model (CEPAC) with India-specific data and results from a randomized trial and examined two strategies for MSM status quo HIV care ( SQ ), and a trial-based psychosocial intervention ( INT ) focused on building resilience to stress, improving mental health, and reducing condomless anal sex (CAS).METHODS:
We projected lifetime clinical and economic outcomes for MSM without HIV initially. Intervention effectiveness, defined as reduction in self-reported CAS, was estimated at 38%; cost was $49.37/participant. We used a willingness-to-pay threshold of US$2100 (2019 Indian per capita GDP) per year of life saved (YLS) to define cost-effectiveness. We also assessed the 5-year budget impact of offering this intervention to 20% of Indian MSM.RESULTS:
Model projections showed the intervention would avert 2940 HIV infections among MSM over 10âyears. Over a lifetime horizon, the intervention was cost-effective (ICERâ=â$900/YLS). Results were most sensitive to intervention effectiveness and cost; the intervention remained cost-effective under plausible ranges of these parameters. Offering this intervention in the public sector would require an additional US$28âM over 5 years compared with SQ .CONCLUSION:
A resilience-based psychosocial intervention integrated with HIV risk reduction counseling among MSM in India would reduce HIV infections and be cost-effective. Programs using this approach should be expanded as a part of comprehensive HIV prevention in India.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
1_ASSA2030
/
2_ODS3
Problema de salud:
1_doencas_nao_transmissiveis
/
1_financiamento_saude
/
2_enfermedades_transmissibles
Asunto principal:
Infecciones por VIH
/
Minorías Sexuales y de Género
Tipo de estudio:
Clinical_trials
/
Health_economic_evaluation
Aspecto:
Patient_preference
Límite:
Female
/
Humans
/
Male
País/Región como asunto:
Asia
Idioma:
En
Revista:
AIDS
Asunto de la revista:
SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS)
Año:
2022
Tipo del documento:
Article