title: Estimating the Cost-Effectiveness of HIV Prevention Programmes in Vietnam, 2006-2010: A Modelling Study.
abstract: BACKGROUND
  Vietnam has been largely reliant on international support in its HIV response. Over 2006-2010, a total of US$480 million was invested in its HIV programmes, more than 70% of which came from international sources. This study investigates the potential epidemiological impacts of these programmes and their cost-effectiveness.
  
  
  METHODS
  We conducted a data synthesis of HIV programming, spending, epidemiological, and clinical outcomes. Counterfactual scenarios were defined based on assumed programme coverage and behaviours had the programmes not been implemented. An epidemiological model, calibrated to reflect the actual epidemiological trends, was used to estimate plausible ranges of programme impacts. The model was then used to estimate the costs per averted infection, death, and disability adjusted life-year (DALY).
  
  
  RESULTS
  Based on observed prevalence reductions amongst most population groups, and plausible counterfactuals, modelling suggested that antiretroviral therapy (ART) and prevention programmes over 2006-2010 have averted an estimated 50,600 [95% uncertainty bound: 36,300-68,900] new infections and 42,600 [36,100-54,100] deaths, resulting in 401,600 [312,200-496,300] fewer DALYs across all population groups. HIV programmes in Vietnam have cost an estimated US$1,972 [1,447-2,747], US$2,344 [1,843-2,765], and US$248 [201-319] for each averted infection, death, and DALY, respectively.
  
  
  CONCLUSIONS
  Our evaluation suggests that HIV programmes in Vietnam have most likely had benefits that are cost-effective. ART and direct HIV prevention were the most cost-effective interventions in reducing HIV disease burden.
authors.affiliation: Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia; Department for Disease Control and Prevention, Pasteur Institute, Ho Chi Minh City, Vietnam.
authors.forename: Quang Duy
authors.initials: QD
authors.lastname: Pham
authors.affiliation: Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia.
authors.forename: David P
authors.initials: DP
authors.lastname: Wilson
authors.affiliation: Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia.
authors.forename: Cliff C
authors.initials: CC
authors.lastname: Kerr
authors.affiliation: Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Shattock
authors.affiliation: Department of Health System, Hanoi School of Public Health, Hanoi, Vietnam.
authors.forename: Hoa Mai
authors.initials: HM
authors.lastname: Do
authors.affiliation: Department of Planning and Finance, Vietnam Administration of HIV/AIDS Control, Hanoi, Vietnam.
authors.forename: Anh Thuy
authors.initials: AT
authors.lastname: Duong
authors.affiliation: Ministry of Heath, Hanoi, Vietnam.
authors.forename: Long Thanh
authors.initials: LT
authors.lastname: Nguyen
authors.affiliation: Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia; School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia; Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia.
authors.forename: Lei
authors.initials: L
authors.lastname: Zhang
mesh_terms: D003362:Cost-Benefit Analysis; D015658:HIV Infections / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D015233:Models, Statistical; D009313:National Health Programs / Q000191:economics; D011322:Primary Prevention / Q000191:economics* / Q000458:organization & administration; D014744:Vietnam