Prioritizing HIV/AIDS prevention strategies in Bandung, Indonesia: A cost analysis of three different HIV/AIDS interventions

Bresser, Inge de; Remers, Toine E. P.; Wieland, Monse W. M.; Prawiranegara, Rozar; Siregar, Adiatma Y. M.; Baltussen, Rob

doi:10.1371/journal.pone.0221078

Cited by 11 publications

(9 citation statements)

References 11 publications

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“…Although costing studies on HIV/AIDS interventions in different settings in Indonesia have been conducted previously [i.e. studies on voluntary counseling and testing (VCT), condom distribution, mobile VCT, religious-based information, education and communication (IEC), sexually transmitted infection (STI) services, outreach to men who have sex with men (MSM), harm reduction community meetings for people who inject drugs (PWID), IEC provision at maternal and child health posts, antiretroviral treatment (ART)] [ [13][14][15][16], they were limited only to one city and none have explored the costs in the context of test-and-treat approach. To our knowledge, this study is the first in Indonesia and Southeast Asia to compare the costs and outcomes of providing an improved test-and-treat approach in community-based and hospital-based clinics.…”

Section: Introductionmentioning

confidence: 99%

Cost of improved test and treat strategies in Indonesia

Hardiawan

Juwita

Vadra

et al. 2023

Aids

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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.

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Section: Introductionmentioning

confidence: 99%

Cost of improved test and treat strategies in Indonesia

Hardiawan

Juwita

Vadra

et al. 2023

Aids

Self Cite

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“…From a societal perspective (i.e., healthcare plus non‐healthcare costs), the estimated PrEP total cost is still 39% lower than the cost of ART per person per year in Indonesia, which is approximately US $600 [19]. Although our calculation did not include the cost of the outreach team, adding the cost of outreach per person per year reported in another study [20] (US $88.43, adjusted using 2022 exchange rate [21]), the cost of PrEP per person would reach US $453.46, still 24% lower than the cost of ART per person in Indonesia. Note that ART is a lifetime treatment, whereas PrEP is provided during certain periods as required and has the potential to avoid ART altogether.…”

Section: Discussionmentioning

confidence: 99%

Cost of implementing HIV pre‐exposure prophylaxis at community‐based clinics in Indonesia

Siregar,

Juwita,

Hardiawan

et al. 2023

Tropical Med Int Health

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IntroductionCurrently, Indonesia still has one of the highest rates of new HIV/AIDS infections among countries in Asia and the Pacific region. The WHO has recommended pre‐exposure prophylaxis (PrEP) as an additional HIV epidemic prevention step, which has been applied globally and related to the reduction in the number of HIV cases. However, information on the cost of implementing PrEP is rarely available in developing countries, especially in Southeast Asia. Designing a cost‐effective approach to scale up PrEP and to estimate the potential budget impact requires information on the cost of implementing PrEP. This study aims to estimate the cost of implementing PrEP at community‐based clinics in Indonesia.MethodsWe collected healthcare and non‐healthcare/client costs from nine community‐based clinics in various cities/districts in Indonesia. The healthcare costs included data on resource utilisation and costs to deliver PrEP, divided into recurrent and capital costs using a discount rate of 3%. Non‐healthcare costs included out‐of‐pocket costs (e.g., transportation, meals) and productivity loss by clients and accompanying person(s) in accessing PrEP. On average, we interviewed 27 clients/clinic.ResultsThe annual cost of providing PrEP per client is US $365.03, 39% lower than the yearly cost of antiretroviral treatment (ART) per person (approximately US $600). Drugs and non‐healthcare costs contribute approximately 67% of the cost. The cost of PrEP amounts to US $292,756.45/year, covering 802 clients. The non‐healthcare cost per visit at all sites never reaches more than 10% of the average monthly household expenditure.ConclusionsThe cost of providing PrEP per person is approximately US $365 and is 39% lower than the annual cost of ART per person. Lowering the cost of PrEP ARV drugs would reduce the cost. Scaling up PrEP should recognise this cost structure and strive to reach economies of scale as the intervention gains more clients while simultaneously controlling new HIV infections.

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“…In response to this situation, the Indonesian government made various efforts to accelerate the response to Covid-19. The presence of Covid-19 has seized the attention of the people and the Indonesian government so that it is enough to drown out the issue of the HIV/AIDS pandemic, which has existed in Indonesia since 1987 (De Bresser et al, 2019;Siregar et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

REBT Module Development in Pastoral Counseling Service for PLHA in Maluku Protestant Church

Noya¹

2022

SOSHUM

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HIV (Human Immunodeficiency Virus) and AIDS (Acquired Immunodeficiency Syndrome) are global pandemics that draw the world's attention. Since 1987, the cases of HIV/AIDS have been declared as a humanitarian crisis and have become a challenge to the development and progress of Indonesia. In addition, as a province with a relatively large number of cases, handling HIV/AIDS is certainly a concern for the government and the church community in Maluku. In the process of pastoral counseling service by Maluku Protestants Church (GPM), the spiritual assistance to the People Living with HIV/AIDS (PLHA) is going well. Even so, they didn’t have guidance from a psychological perspective such as therapy or other methods to strengthen the assistance. To this concern, this study aims to develop a module of Rational Emotive Behavior Therapy (REBT) in pastoral counseling service for PLHA in Maluku Protestants Church. The method used in the study was a Research and Development with ADDIE Model. There are five procedural stages of developing the module based on this model namely, analysis, design, development, implementation and evaluation. The subject in the study were the servants of pastoral counseling in the Maluku Protestants Church who are spread in three service areas such as in Masohi City and Lease Islands (in Central Maluku Regency) and Ambon City (the capital of Maluku). The results conclude that the REBT module is effective for the pastoral counseling service to the PLHA in Maluku Protestants Church.

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Prioritizing HIV/AIDS prevention strategies in Bandung, Indonesia: A cost analysis of three different HIV/AIDS interventions

Cited by 11 publications

References 11 publications

Cost of improved test and treat strategies in Indonesia

Cost of improved test and treat strategies in Indonesia

Cost of implementing HIV pre‐exposure prophylaxis at community‐based clinics in Indonesia

REBT Module Development in Pastoral Counseling Service for PLHA in Maluku Protestant Church

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