Trial in China Demonstrates Cost-Effective Streamlining of HIV Testing and Access to Treatment

published on January 9, 2017

January 9, 2017 [Vancouver, BC] New research from the BC Centre for Excellence in HIV/AIDS (BC-CfE) shows an intervention in a Southern Chinese province to streamline the process for a person diagnosed with HIV to reach care is cost-effective, by averting HIV cases and deaths. The study trial offers a blueprint for expanding access to HIV treatment in China by reducing the number of hospital visits required to access HIV counselling and care.

To enhance HIV testing and subsequent treatment uptake in the Guangxi Zhuang Autonomous Region in China, the Chinese Centre for Disease Control and Prevention (China CDC) in collaboration with the US National Institutes of Health (NIH)/National Institute on Drug Abuse (NIDA) executed a cluster-randomized trial to assess the cost-effectiveness of a more streamlined HIV testing process.

The trial results, published in the PLOS One peer-reviewed journal, show the intervention of more streamlined testing would be highly cost-effective if implemented across the Guangxi province. This includes in scenarios where the intervention only minimally increased HIV testing. Within a five-year study period, the additional costs of ART (an increment of Chinese Yuan Renminbi, or CNY, of 6.2 million) were offset by savings of CNY 17.5 million in non-ART medical costs—even incorporating the higher costs of the more streamlined screening process.

The intervention remained cost-effective over a twenty-five year horizon due to the substantial increase in access to HIV treatment, resulting in increases in quality of life and longevity (CNY 11,678 per quality-adjusted life-years gained).

“Implementing the new testing strategy across China proved to provide a more efficient pathway for patients navigating the health system, which could save lives,” said Dr. Bohdan Nosyk, BC-CfE Research Scientist. “This approach would be further improved alongside other public health strategies to seek, test, treat and maintain on treatment people living with HIV and AIDS.”

China has had a strong working relationship with the Government of BC in addressing the HIV epidemic. The Chinese government signed a memorandum of understanding with the BC-CfE, as witnessed by BC Premier Christy Clark at an event in Beijing on November 26, 2013. At the time of the signing Dr. Zunyou Wu, Director of the National Centre for AIDS/STI Control at the China CDC, credited British Columbia with being an international leader addressing the global HIV epidemic.

China was the first country to adopt the made-in-BC Treatment as Prevention or TasP and has since been joined by others—including Spain, France, Brazil and Panama. TasP® means expanding earlier access to HIV testing, and providing immediate, universal access to HIV treatment to all those who are medically eligible. The trial results in Guangxi echo previous research linking the expansion of the TasP® model to lower health care costs and to a more sustainable health care system.

“We know that providing a Treatment as Prevention public health approach is a key to improving the health, wellbeing and longevity of those living with HIV,” said Dr. Julio Montaner, Director of the BC-CfE, who has worked in consultation with the China CDC on addressing the country’s HIV epidemic. “Our research shows expanding access to treatment works universally across many different settings, and is a path forward to reaching an AIDS-free generation globally.”

BACKGROUND

About the British Columbia Centre for Excellence in HIV/AIDS
The BC Centre for Excellence in HIV/AIDS (BC-CfE—http://cfenet.ubc.ca) is Canada’s largest HIV/AIDS research, treatment and education facility and is internationally recognized as an innovative world leader in combating HIV/AIDS and related diseases. BC-CfE is based at St. Paul’s Hospital, Providence Health Care, a teaching hospital of the University of British Columbia. The BC-CfE works in close collaboration with key provincial stakeholders, including government, health authorities, health care providers, academics from other institutions, and the community to decrease the health burden of HIV and AIDS. By developing, monitoring and disseminating comprehensive research and treatment programs for HIV and related illnesses, the BC-CfE helps improve the health of British Columbians.

About Treatment as Prevention (TasP)
TasP®, pioneered by the BC-CfE, consists of widespread HIV testing and the immediate offer of HIV treatment (highly active antiretroviral therapy, also known as HAART) to those who test positive. TasP® has been proven to greatly improve a patient’s quality of life, prevent progression to AIDS and extend longevity by decades, while reducing the likelihood of transmission to negligible. Within BC, TasP® has led to an 88% decline in new AIDS cases and a 65% per cent drop in new HIV cases in BC since 1994. The United Nations/UNAIDS 90-90-90 Target to end AIDS by 2030 is based on principles of TasP®. By 2020, the goal is for 90% of all those living with HIV to be diagnosed, 90% of those diagnosed to be on treatment and 90% of those on treatment to have an undetectable viral load. On World AIDS Day 2015 (December 1), the Canadian federal government formally embraced TasP® based on the pioneering work of the BC-CfE.

For additional information or to request interviews, please contact:
Caroline Dobuzinskis, BC-CfE
Cell: 604-366-6540, Phone: 604-682-2344 ext. 66536
Email: cdobuzin@cfenet.ubc.ca

-END-

Tags:

Treatment as Prevention®

Julio Montaner

BC Centre for Excellence in HIV/AIDS

Search form

Trial in China Demonstrates Cost-Effective Streamlining of HIV Testing and Access to Treatment

Search form