(P108) Optimizing healthcare resource allocation for HIV testing in China

Tuesday, July 25, 2023

16:00 – 18:00 CST

Primary Presenter(s)

Lei Zhang, PhD (he/him/his)

Professor
Central Clinical School, Monash University
Carlton, Victoria, Australia

Co-author(s)

SH

Shihao He

China-Australia Joint Research Centre for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Centre, United States
WD

Wei Dong

National Center for AIDS/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC), Beijing 102206, China, United States
ZL

Zengbin Li

China-Australia Joint Research Centre for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Centre, United States
YW

Yudong Wei

China-Australia Joint Research Centre for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Centre, United States
HL

Hao Lai

China-Australia Joint Research Centre for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Centre, United States
RL

Rui Li

China-Australia Joint Research Centre for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Centre, United States
PL

Pengyi Lu

China-Australia Joint Research Centre for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Centre, United States
MS

Mingwang Shen

China-Australia Joint Research Centre for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Centre, United States
ZW

Zunyou Wu

National Center for AIDS/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC), Beijing 102206, China, United States

Background:

The Joint United Nations Programme updated a goal of 95-95-95 targets for the endgame of HIV. We investigate the optimal strategy of health resource allocation to improve HIV testing in both high-risk and general populations in China .

Methods:

We developed a mathematical model by integrating epidemiological, demographical and behavioural data from 12 high-risk and 2 general populations to evaluate the impact of various HIV testing strategies on HIV incidence in China. We identified the optimal testing strategy that maximizes the number of HIV diagnoses at a given cost and calculated the cost of detecting one new HIV case.

Results:

We estimated the current annual spending on HIV testing to be US$366.8 million. The largest proportion of spending has been allocated to pregnant women (25.90%), followed by the general male (20.33%), and general female (20.06%). With this allocation strategy, an estimated 37.55% (37,546/100,141) of annual new infections would be diagnosed. Overall, it required $9771 for each new HIV case detection. After optimizing HIV testing resource allocation of the same investment amount, the proportion of investment allocation was the highest in low-risk MSM (26.65%), followed by the PWID (21.01%), and high-risk MSM (0.93%). With the optimized strategy, we estimated that 67,684 (67.59%) of annual new infections would be diagnosed. The cost required for one HIV case detection was reduced to $5619/case. If the budget for HIV testing increased to 5-10 times the baseline level, healthcare sources may be then shifted to low-risk populations.

Conclusions:

Optimizing resource allocation for HIV testing in high-risk populations would result in a higher HIV diagnosis rate and lower cost per HIV case detection.