Table 3.
Estimated HIV and syphilis infections, and cost-effectiveness of increased HIV and dual HIV/syphilis testing among key populations in Viet Nam from 2020 to 2035
| Scenario | |||||||
| Baseline | 1 dual test | 1 HIV test | 1 HIV and 1 dual | 2 HIV tests | 2 dual tests | ||
| HIV | New HIV infections | 57 902 | 54 696 | 54 696 | 53 821 | 53 821 | 53 821 |
| AIDS deaths | 13 877 | 13 217 | 13 217 | 13 034 | 13 034 | 13 034 | |
| Total HIV DALYs | 174 567 240 | 174 508 007 | 174 508 007 | 174 490 608 | 174 490 608 | 174 490 608 | |
| Syphilis | Total cases treated | 88 953 | 116 680 | 88 953 | 116 680 | 88 953 | 177 354 |
| Total DALYs treated | 2831 | 3713 | 2831 | 3713 | 2831 | 5644 | |
| Incremental cases averted | HIV infections averted | – | 3206 | 0 | 875 | 0 | 0 |
| HIV DALYs averted | – | 59 233 | 0 | 17 399 | 0 | 0 | |
| Syphilis cases treated | – | 27 727 | −27,727 | 27 727 | −27,727 | 88 401 | |
| Syphilis DALYs averted | – | 882 | −882 | 882 | −882 | 2813 | |
| Total DALYs averted (HIV and syphilis) | – | 60 115 | −882 | 18 281 | −882 | 2813 | |
| Costs (USD) |
Net costs | $31 036 672 | $31 659 182 | $33 094 783 | $51 942 954 | $53 378 555 | $62 896 039 |
| HIV testing | $16 491 955 | – | $24 683 204 | $22 142 027 | $46 825 230 | – | |
| HIV treatment averted | – | -$6 133 138 | -$6 133 138 | -$7 991 393 | -$7 991 393 | -$7 991 393 | |
| Syphilis testing | $14 084 698 | $1 535 409 | $14 084 698 | $1 535 409 | $14 084 698 | $2 333 826 | |
| Syphilis treatment | $460 019 | $603 395 | $460 019 | $603 395 | $460 019 | $917 162 | |
| Dual testing | – | $35 653 516 | – | $35 653 516 | – | $67 636 444 | |
| Total incremental costs | – | $622 510 | $1 435 601 | $18 848 171 | $1 435 601 | $9 517 484 | |
| ICERs (cost per DALY averted) | – | $10 | Dom | $1166 | Dom | $5672 | |
Each scenario refers to the number of tests per year. The baseline scenario assumes that 50% of key populations are tested for HIV each year and syphilis testing rates are specific to each subpopulation (FSW, MSM and PWID). Scenarios including one test per year assume a 75% test acceptance rate, and those that include two tests per year assume a 75% test acceptance rate for the first test, and a 68.5% test acceptance rate for the second test. Incremental cases averted, total DALYs averted and ICERs compare each scenario to the previous one.
DALY, disability-adjusted life-years; FSW, female sex workers; ICERs, incremental cost-effectiveness ratios; MSM, men who have sex with men; PWID, people who inject drugs.