Optimizing health resource allocation for improving timely HIV diagnosis in China
Abstract Introduction The Joint United Nations Programme on HIV/AIDS (UNAIDS) updated the 95‐95‐95 targets for the HIV endgame in 2030. To achieve the first target in a timely manner, we investigate the optimized strategy of resource allocation to maximize timely HIV diagnosis in 14 populations in C...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2024-03-01
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| Series: | Journal of the International AIDS Society |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/jia2.26221 |
| _version_ | 1797242791532691456 |
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| author | Shihao He Wei Dong Christopher K. Fairley Zengbin Li Yudong Wei Hao Lai Rui Li Pengyi Lu Mingwang Shen Zunyou Wu Lei Zhang |
| author_facet | Shihao He Wei Dong Christopher K. Fairley Zengbin Li Yudong Wei Hao Lai Rui Li Pengyi Lu Mingwang Shen Zunyou Wu Lei Zhang |
| author_sort | Shihao He |
| collection | DOAJ |
| description | Abstract Introduction The Joint United Nations Programme on HIV/AIDS (UNAIDS) updated the 95‐95‐95 targets for the HIV endgame in 2030. To achieve the first target in a timely manner, we investigate the optimized strategy of resource allocation to maximize timely HIV diagnosis in 14 populations in China. Methods We developed a mathematical model by integrating epidemiological, demographical and behavioural data from 12 high‐risk and two general populations to evaluate the impact of various resource allocation strategies of HIV testing on HIV incidence in China. We identified the optimized allocation strategy that maximizes the number of HIV diagnoses at an estimated total spending on HIV tests in China and calculated the per‐capita cost of new HIV case detection. Results We estimated that 144,795 new HIV cases may occur annually in 14 populations in China, with a total annual spending of US$2.8 billion on HIV testing. The largest proportion of spending was allocated to general males (44.0%), followed by general females (42.6%) and pregnant women (5.1%). Despite this allocation strategy, only 45.5% (65,867/144,795, timely diagnosis rate) of annual new infections were diagnosed within a year of acquisition, with a cost of $42,852 required for each new HIV case detection. By optimizing the allocation of HIV testing resources within the same spending amount, we found that general females received the highest proportion of spending allocation (45.1%), followed by low‐risk men who have sex with men (13.9%) and pregnant women (8.4%). In contrast, the proportion of spending allocation for the general males decreased to 0.2%. With this optimized strategy, we estimated that 120,755 (83.4%) of annual new infections would be diagnosed within a year of acquisition, with the cost required for one HIV case detection reduced to $23,364/case. Further spending increases could allow for significant increases in HIV testing among lower‐risk populations. Conclusions Optimizing resource allocation for HIV testing in high‐risk populations would improve HIV timely diagnosis rate of new infections and reduce cost per HIV case detection. |
| first_indexed | 2024-04-24T18:44:50Z |
| format | Article |
| id | doaj.art-05f4a54cfdb9417d98a141541ce052d6 |
| institution | Directory Open Access Journal |
| issn | 1758-2652 |
| language | English |
| last_indexed | 2024-04-24T18:44:50Z |
| publishDate | 2024-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the International AIDS Society |
| spelling | doaj.art-05f4a54cfdb9417d98a141541ce052d62024-03-27T07:08:46ZengWileyJournal of the International AIDS Society1758-26522024-03-01273n/an/a10.1002/jia2.26221Optimizing health resource allocation for improving timely HIV diagnosis in ChinaShihao He0Wei Dong1Christopher K. Fairley2Zengbin Li3Yudong Wei4Hao Lai5Rui Li6Pengyi Lu7Mingwang Shen8Zunyou Wu9Lei Zhang10China‐Australia Joint Research Center for Infectious Diseases School of Public Health Xi'an Jiaotong University Health Science Center Xi'an ChinaNational Center for AIDS/STD Control and Prevention (NCAIDS) Chinese Center for Disease Control and Prevention (China CDC) Beijing ChinaMelbourne Sexual Health Centre Alfred Health Melbourne Victoria AustraliaChina‐Australia Joint Research Center for Infectious Diseases School of Public Health Xi'an Jiaotong University Health Science Center Xi'an ChinaChina‐Australia Joint Research Center for Infectious Diseases School of Public Health Xi'an Jiaotong University Health Science Center Xi'an ChinaChina‐Australia Joint Research Center for Infectious Diseases School of Public Health Xi'an Jiaotong University Health Science Center Xi'an ChinaChina‐Australia Joint Research Center for Infectious Diseases School of Public Health Xi'an Jiaotong University Health Science Center Xi'an ChinaChina‐Australia Joint Research Center for Infectious Diseases School of Public Health Xi'an Jiaotong University Health Science Center Xi'an ChinaChina‐Australia Joint Research Center for Infectious Diseases School of Public Health Xi'an Jiaotong University Health Science Center Xi'an ChinaNational Center for AIDS/STD Control and Prevention (NCAIDS) Chinese Center for Disease Control and Prevention (China CDC) Beijing ChinaChina‐Australia Joint Research Center for Infectious Diseases School of Public Health Xi'an Jiaotong University Health Science Center Xi'an ChinaAbstract Introduction The Joint United Nations Programme on HIV/AIDS (UNAIDS) updated the 95‐95‐95 targets for the HIV endgame in 2030. To achieve the first target in a timely manner, we investigate the optimized strategy of resource allocation to maximize timely HIV diagnosis in 14 populations in China. Methods We developed a mathematical model by integrating epidemiological, demographical and behavioural data from 12 high‐risk and two general populations to evaluate the impact of various resource allocation strategies of HIV testing on HIV incidence in China. We identified the optimized allocation strategy that maximizes the number of HIV diagnoses at an estimated total spending on HIV tests in China and calculated the per‐capita cost of new HIV case detection. Results We estimated that 144,795 new HIV cases may occur annually in 14 populations in China, with a total annual spending of US$2.8 billion on HIV testing. The largest proportion of spending was allocated to general males (44.0%), followed by general females (42.6%) and pregnant women (5.1%). Despite this allocation strategy, only 45.5% (65,867/144,795, timely diagnosis rate) of annual new infections were diagnosed within a year of acquisition, with a cost of $42,852 required for each new HIV case detection. By optimizing the allocation of HIV testing resources within the same spending amount, we found that general females received the highest proportion of spending allocation (45.1%), followed by low‐risk men who have sex with men (13.9%) and pregnant women (8.4%). In contrast, the proportion of spending allocation for the general males decreased to 0.2%. With this optimized strategy, we estimated that 120,755 (83.4%) of annual new infections would be diagnosed within a year of acquisition, with the cost required for one HIV case detection reduced to $23,364/case. Further spending increases could allow for significant increases in HIV testing among lower‐risk populations. Conclusions Optimizing resource allocation for HIV testing in high‐risk populations would improve HIV timely diagnosis rate of new infections and reduce cost per HIV case detection.https://doi.org/10.1002/jia2.26221cost for new case detectionhigh‐risk and general populationHIV testingmathematical modellingoptimized resource allocationtimely diagnosis |
| spellingShingle | Shihao He Wei Dong Christopher K. Fairley Zengbin Li Yudong Wei Hao Lai Rui Li Pengyi Lu Mingwang Shen Zunyou Wu Lei Zhang Optimizing health resource allocation for improving timely HIV diagnosis in China Journal of the International AIDS Society cost for new case detection high‐risk and general population HIV testing mathematical modelling optimized resource allocation timely diagnosis |
| title | Optimizing health resource allocation for improving timely HIV diagnosis in China |
| title_full | Optimizing health resource allocation for improving timely HIV diagnosis in China |
| title_fullStr | Optimizing health resource allocation for improving timely HIV diagnosis in China |
| title_full_unstemmed | Optimizing health resource allocation for improving timely HIV diagnosis in China |
| title_short | Optimizing health resource allocation for improving timely HIV diagnosis in China |
| title_sort | optimizing health resource allocation for improving timely hiv diagnosis in china |
| topic | cost for new case detection high‐risk and general population HIV testing mathematical modelling optimized resource allocation timely diagnosis |
| url | https://doi.org/10.1002/jia2.26221 |
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