{"id":1406,"date":"2026-07-30T18:10:46","date_gmt":"2026-07-30T14:40:46","guid":{"rendered":"https:\/\/salamatejensi.com\/?p=1406"},"modified":"2026-07-30T18:10:46","modified_gmt":"2026-07-30T14:40:46","slug":"hiv-aids-treatment-cost-estimation-vct-center","status":"publish","type":"post","link":"https:\/\/salamatejensi.com\/en\/googles-schoolar\/hiv-aids-treatment-cost-estimation-vct-center\/","title":{"rendered":"An Estimation of HIV\/AIDS\u2019s Cost in the Voluntary Counseling and Testing Center of Imam Khomeini Hospital in 2010-2011"},"content":{"rendered":"

Abstract<\/strong>:<\/p>\n

Introduction: Undoubtedly, HIV\/AIDS is one of the most important emerging infectious disease in the late twentieth century; and its control is possible only with proper and organized program. To attain this goal, one of the most serious issues is the budget planning and distribution. The present study calculated the total costs of AIDS in Voluntary Counseling and Testing center of Imam Khomeini Hospital in 2010-2011.<\/p>\n

Methods: The total cost of AIDS at this center was divided into four categories: health care, training and educating, research and services.<\/p>\n

All costs for 2010-2011 were extracted and classified based on documents and bills which were found in the center. Results: According to the calculations, the center had a total of 6,603,479,058 IRR in 2010-2011, of which 49.5% (3,271,089,796 IRR) was allocated for health care expenditure, 20.3% (1,335,186,000 IRR) for research, 12.6% (834,000,000 IRR) for training and 17.6% (1,163,203,262 IRR) for services. The average expense for each person living with HIV was 2276 US dollars. The cost of treatment by drugs for each person eligible for treatment was 782 US dollars. Conclusion: The percentage of budget distribution in the center is equal to the same percentage in low and middle income countries; although, more percentage is allocated for research than the mentioned countries. Also, the expenditure spent for treatment by drugs is more than the average of the same found in low and middle income countries. Overall, the budget distribution in this center is almost in accordance with the international standards.<\/p>\n

INTRODUCTION<\/p>\n

AIDS is characterized by the progressive destruction of a person\u2019s immune system and is the late and most serious stage of HIV infection [1]. Globally, an estimated 35.3 (32.2\u201338.8) million people were living with HIV in 2012. An increase from previous years as more people are receiving the life-saving antiretroviral therapy. There were 2.3 (1.9\u20132.7) million new HIV infections globally, showing a 33% decline in the number of new infections from 3.4 (3.1\u20133.7) million in 2001. At the same time the number of AIDS deaths is also declining with 1.6 (1.4\u20131.9) million AIDS deaths in 2012, down from 2.3 (2.1\u20132.6) million in 2005 [2].<\/p>\n

The medical cost and economic burden to society of the HIV\/AIDS epidemic have attracted some but<\/p>\n

substantially less attention. Early costing studies in the pre-ART (antiretroviral therapy) era examined the direct medical costs associated with the morbidity and mortality of AIDS focusing mainly on the costs of hospitalization [3]. The economic burden measured by direct medical costs has shifted from inpatient costs (i.e., hospitalization) to outpatient costs primarily reflected as the cost of the antiretroviral drugs, outpatient visits, and laboratory tests [3-5]. Furthermore, HIV prevalence is increasing in western countries as a consequence of falling death rates [1].<\/p>\n

Information on the direct costs of treatment is important since it provides a basis for health planners to allocate budgets or reimburse specific categories of expenditures. It also enables policymakers, when faced with changes in prevalence, that currently occurring with the spread of HIV infection among injection drug users to make more informed choices between programmes. To optimally allocate scarce economic resources to prevention and treatment programmes, planners require accurate, up-to-date estimates of the direct costs of treatment [1, 6]. Although economic evaluation is an important approach for establishing priorities for health interventions [1, 7, 8], in practice this type of evaluation has been of limited value in HIV\/AIDS because of the paucity of accurate cost data [1, 9].<\/p>\n

According to statistics collected from medical schools and health services In Islamic Republic of Iran, till October of 2013, the total contracting HIV\/AIDS was reported 26125 that 89.8% were male and 10.2% were female [10].<\/p>\n

Whereas the death and disease of HIV\/AIDS is common in countries with low\/middle income, good investments are more important than ever. With estimation of HIV\/AIDS cost, the programme managers and planners dealing with HIV\/AIDS to make informed decisions about resource allocation and also in responding to the HIV\/AIDS epidemic the costs and consequences of the initiatives proposed in an AIDS programme must be known to the decision-makers to make best use of scarce resources.<\/p>\n

The estimation cost of HIV\/AIDS is studied in many countries and many articles described it, for example Dodds.C et.al studied the cost of HIV\/AIDS in Canada in 1999. According to their study, total direct costs of HIV\/AIDS was $600 million a year, the shift to expensive highly active antiretroviral therapy (HAART) treatments in 1996, that delay the onset of AIDS and prolong the lives of HIV patients, has increased direct patient costs. Average monthly health care costs per person for the four HIV\/AIDS stages increased by 120% for the CD4 count >500 cells\/\u00b5L, by 85% for the 499-200 cells\/\u00b5L, by 51% for the 199-75 cells\/\u00b5L, and by 21% for AIDS victims (CD4 count <75 cells\/\u00b5L) following the introduction of HAART [11, 12]. The aim of this study was to calculate the cost of HIV\/AIDS in the Voluntary Counseling and Testing (VCT) Center of Imam Khomeini Hospital between 2010-2011.<\/p>\n

MATERIALS AND METHODS<\/strong><\/p>\n

All clients of AIDS counseling center receive counseling and visiting services of this center. But from clients of AIDS counseling center, there are cases that refer to this center just for fear of HIV infection or for gain information about AIDS and the ways of HIV transmission, these cases are guided by the counseling center without enrolling in the center. Only cases with risky behavior, are enrolled and taken the initial testing. After HIV infection is confirmed by testing, to accept the current situation, consultation is done by the center\u2019s aware counselor. After this, if the infected person be married, with consent of the person, to accept in the family, disease process, the way of transmission, particularly of sexually, prevention ways of infection and how to use condom, consultation will be given to the spouse. If the person be single, just with consent of the person and in the necessity to emotionally and clinical support, family counseling will be done and the acceptance of an infected person in the family is emphasized. This is assured that despite living with an infected person, the HIV is not transmitted and also disease process, the way of transmission will explain and testing for the presence of HIV for family if they had a risky behavior is emphasized. Then, the practitioner examines the patient carefully and record diagnostic findings in the form of clinical assessment of HIV\/AIDS. To confirm and finalize the diagnosis from people who have a positive ELISA test, ELISA test is done again and also a Western Blot test is done for these patients. By definition, we say that a person is HIV positive and suffering from AIDS when CD4 count is declined under 200 cells per microliter or the person suffering from one of the cellular immunity disease, so medication for these patients begins. This study was cross-sectional and descriptive and was based on all patients that referred to the counseling center in 2010 and received one of the services that this center provides. The information gathered through study the documents, questionnaires and interviews with staff of center. To calculate the cost in the VCT Center of Imam Khomeini Hospital in 2010-2011, these costs were classified into four sections and the cost of every section was calculated and these costs were summed.<\/p>\n

These sections were:<\/strong><\/p>\n

Health-therapeutic that contains test and imaging, drug and vaccine b. Training that contains publish of AIDS book and publish leaflet and posters, seminar, congress, nutrition workshops and educational workshops of positive club c. Research that contains first three months, second three months, third three months and fourth three months. d. Services that contains personnel of VCT, equipment of VCT, setting up new sexually transmitted infections (STIs) unit, telephone of<\/p>\n

Table 1: Number of Patients that Referred to the Center and Number of Patients with Positive HIV and AIDS and Number of Patients that Received Treatment<\/p>\n

\"\"<\/a><\/p>\n

VCT, water, electricity and fuel consumption and positive club. Profile of clients to the center was confidential. For<\/p>\n

\"\"<\/p>\n

data analysis, SPSS (19) software was used. RESULTS In this study, 9271 people were referred to the counseling center. Number of patients that referred to the center and number of patients with positive HIV and AIDS and number of patients that catch treatment are displayed in Table 1. As it was mentioned, the total cost includes Healththerapeutic, training, research and services cost. Table 2 displays the cost of these sections separately. Table 2: The Cost of Health-Therapeutic, Training, Research and Services in the VCT Center of Imam Khomeini Hospital in 2010-2011<\/p>\n

\n

\n

\n

\n

DISCUSSION<\/p>\n

According to the results of this study, the distribution of money spent on HIV\/AIDS in the Imam Khomeini VCT center in 2010-2011 is relatively similar to low and middle income countries. In both cases most of the cost is for health therapeutic, while the cost for research in low and middle income countries was<\/p>\n

relatively low (8% in 2008) but this cost is more in the Imam Khomeini VCT center (20.3% in 2010-2011). This issue shows that the research in this center is important. The VCT center of Imam Khomeini Hospital has spent on average 2276$ for each person with HIV\/ AIDS in 2010-2011, compared to the corresponding figure in low and middle income countries, more funding for each person is allocated. According to the results, in comparison with other countries, the price of drugs in Iran is high. The cost of training was 12.6% of total cost and this offered that more cost must be allocated for training. Also, this center is one of the most important center in Iran in the field of HIV\/AIDS control, the cost that is allocated for patients and drugs\u2019 research and training and services are more than the country\u2019s average, so similar centers in various province must be consider and the existence of a proper reference for the number of patients and mortality of AIDS to future studies is important.<\/p>\n

CONFLICT OF INTEREST<\/p>\n

The authors have no conflict of interest.<\/p>\n

AUTHORS<\/p>\n

Seyyed Mossa Zeynolabedin1 , Hossein Jabbari1,2, Zahra Bayat Jozani3,4, Mahboubeh Haji Abdolbaghi3,*, Minoo Mohraz3 , Arefe Arabzade3 , Molloud Farrokhi3 and SeyedAhmad SeyedAlinaghi3<\/p>\n

1 Department of Disaster Public Health, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran 2 Department of Infectious Diseases and Tropical Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran 3 Iranian Research Center for HIV\/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran 4 Midwifery and Reproductive Health Department, Alborz University of Medical Sciences, Karaj, Iran<\/p>\n

REFERENCES<\/p>\n

[1] Levy AR, James D, Johnston KM, Hogg RS, Harrigan PR, Harrigan BP, et al. The direct costs of HIV\/AIDS care. The Lancet Infectious Diseases 2006; 6(3): 171-7. https:\/\/doi.org\/10.1016\/S1473-3099(06)70413-3 [2] Organization WH. Global report: UNAIDS report on the global AIDS epidemic 2013.<\/p>\n

[3] Krentz HB, Gill MJ. The Direct Medical Costs of Late Presentation. AIDS research and treatment 2011; 2012. [4] Montaner JS, Hogg RS, Weber AE, Anis AH, O’Shaughnessy MV, Schechter MT. The costs of triple-drug anti-HIV therapy for adults in the Americas. JAMA: The Journal of the American Medical Association 1998; 279(16): 1263-4. https:\/\/doi.org\/10.1001\/jama.279.16.1259 [5] Gebo KA, Chaisson RE, Folkemer JG, Bartlett JG, Moore RD. Costs of HIV medical care in the era of highly active antiretroviral therapy. Aids 1999; 13(8): 963-9. https:\/\/doi.org\/10.1097\/00002030-199905280-00013 [6] Holtgrave DR, Pinkerton SD. Updates of cost of illness and quality of life estimates for use in economic evaluations of HIV prevention programs. JAIDS Journal of Acquired Immune Deficiency Syndromes 1997; 16(1): 54-62. https:\/\/doi.org\/10.1097\/00042560-199709010-00009 [7] Yazdanpanah Y, Goldie SJ, Losina E, Weinstein MC, Lebrun T, Paltiel AD, et al. Lifetime cost of HIV care in France during the era of highly active antiretroviral therapy. Antiviral Therapy 2002; 7(4): 257-66. [8] Drummond MF, O\u2019Brien B, Stoddart GL, Torrance GW. Methods for the economic evaluation of health care programmes. Oxford: Oxford University Press, 05. [9] Beck EJ, Miners AH, Tolley K. The cost of HIV treatment and care. Pharmacoeconomics 2001; 19(1): 13-39. https:\/\/doi.org\/10.2165\/00019053-200119010-00002 [10] Latest statistics on HIV\/AIDS infection in Islamic Republic of Iran. Ministry of Health and Medical Education, Center for Disease Control 2012; [in persian]. [11] Dodds C, Colman R, Amaratunga C, Wilson J. The Cost of HIV\/AIDS in Canada. GPI Atlantic, Halifax 2000. [12] Sardashti S, Samaei M, Firouzeh MM, Mirshahvalad SA, Pahlaviani FG, SeyedAlinaghi S. Early initiation of antiretroviral treatment: Challenges in the Middle East and North Africa. World J Virol 2015; 4(2): 134-41. https:\/\/doi.org\/10.5501\/wjv.v4.i2.134<\/p>\n

Received on 30-06-2018 Accepted on 20-07-2018 Published on 14-12-2018 DOI: https:\/\/doi.org\/10.12970\/2309-0529.2018.06.07 \u00a9 2018 Zeynolabedin et al.; Licensee Synergy Publishers. This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.<\/p>\n","protected":false},"excerpt":{"rendered":"

Abstract: Introduction: Undoubtedly, HIV\/AIDS is one of the most important emerging infectious disease in the late twentieth century; and its control is possible only with proper and organized program. To attain this goal, one of the most serious issues is the budget planning and distribution. 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