Economic evaluation of improving HIV self-testing among MSM in China using a crowdsourced intervention: A cost-effectiveness analysis

Jason J. Ong, Ross D. Booton, Joseph D. Tucker, Weiming Tang, Peter Vickerman, Lei Zhang, Kate M. Mitchell

Research output: Contribution to journalArticleResearchpeer-review

4 Citations (Scopus)

Abstract

Objectives:Crowdsourcing, which taps into the wisdom of crowds, has been successful in generating strategies to enhance HIV self-testing (HIVST) uptake. We determined the cost-effectiveness of a crowdsourced intervention (one-off or annual) compared with a control scenario (no crowdsourcing) among MSM living in China.Design:Economic evaluation.Methods:We used data from our cluster randomized controlled trial of MSM (NCT02796963). We used a micro-costing approach to measure direct health costs ($USD2017) from a health provider perspective. Using outputs from a dynamic transmission model over a 20-year time horizon, we estimated the incremental cost-effectiveness ratios using cost per disability-adjusted life years (DALYs) averted with 3% discounting. An intervention was considered highly cost-effective if it was less than one gross domestic product (GDP, $8823) per DALY averted.Results:Across all cities, the crowdsourced intervention was highly cost-effective compared with the control scenario (incremental cost-effectiveness ratios ranged from $2263 to 6152 per DALY averted for annual crowdsourcing; $171 to 204 per DALY averted for one-off crowdsourcing). The one-off intervention was cost-saving in Guangzhou and Qingdao. Sensitivity analyses confirmed the robustness of the findings; specifically, changes in discounting, costs of the crowdsourced intervention, costs of HIV testing and cost of antiretroviral therapy did not alter our conclusions.Conclusion:Scaling up a one-off or annual crowdsourced HIV prevention intervention in four cities in China was very likely to be cost-effective. Further research is warranted to evaluate the feasibility of scaling up crowdsourced HIV prevention interventions in other settings and populations.

Original languageEnglish
Pages (from-to)671-678
Number of pages8
JournalAIDS
Volume37
Issue number4
DOIs
Publication statusPublished - 15 Mar 2023

Keywords

  • crowdsourcing
  • economic evaluation
  • HIV
  • HIV self-testing
  • MSM

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