title: Cost-effectiveness of scaling up voluntary counselling and testing in West-Java, Indonesia.
abstract: OBJECTIVE
  to evaluate the costs-effectiveness of scaling up community-based VCT in West-Java.
  
  
  METHODS
  the Asian epidemic model (AEM) and resource needs model (RNM) were used to calculate incremental costs per HIV infection averted and per disability-adjusted life years saved (DALYs). Locally monitored demographic, epidemiological behavior and cost data were used as model input.
  
  
  RESULTS
  scaling up community-based VCT in West-Java will reduce the overall population prevalence by 36% in 2030 and costs US$248 per HIV infection averted and US$9.17 per DALY saved. Cost-effectiveness estimation were most sensitive to the impact of VCT on condom use and to the population size of clients of female sex workers (FSWs), but were overall robust. The total costs for scaling up community-based VCT range between US$1.3 and 3.8 million per year and require the number of VCT integrated clinics at public community health centers to increase from 73 in 2010 to 594 in 2030.
  
  
  CONCLUSIONS
  scaling up community-based VCT seems both an effective and cost-effective intervention. However, in order to prioritize VCT in HIV/AIDS control in West-Java, issues of budget availability and organizational capacity should be addressed.
authors.affiliation: Department of Primary and Community Care, Radboud University Nijmegen Medical Centre, NICHE (Nijmegen International Center for Health Systems Research and Education). PO Box 9101, 6500 HB Nijmegen, The Netherlands. n.tromp@elg.umcn.nl
authors.forename: Noor
authors.initials: N
authors.lastname: Tromp
authors.forename: Adiatma
authors.initials: A
authors.lastname: Siregar
authors.forename: Barnabas
authors.initials: B
authors.lastname: Leuwol
authors.forename: Dindin
authors.initials: D
authors.lastname: Komarudin
authors.forename: Andre
authors.initials: A
authors.lastname: van der Ven
authors.forename: Reinout
authors.initials: R
authors.lastname: van Crevel
authors.forename: Rob
authors.initials: R
authors.lastname: Baltussen
mesh_terms: D057191:Capacity Building / Q000191:economics; D003153:Community Health Services / Q000191:economics*; D017280:Condoms / Q000706:statistics & numerical data*; D003362:Cost-Benefit Analysis; D003376:Counseling / Q000191:economics*; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000191:economics / Q000517:prevention & control*; D018451:Homosexuality, Male; D006801:Humans; D007214:Indonesia; D008297:Male; D011477:Sex Work; D019966:Substance-Related Disorders / Q000150:complications; D014838:Volunteers / Q000706:statistics & numerical data*