Division of Global HIV and TB, Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, GA 30329, USA.
Eswatini Ministry of Health, Mbabane P.O. Box 5, Eswatini.
Int J Environ Res Public Health. 2022 Dec 20;20(1):38. doi: 10.3390/ijerph20010038.
The success of antiretroviral therapy (ART) requires continuous engagement in care and optimal levels of adherence to achieve sustained HIV viral suppression. We evaluated HIV-care cascade costs and outcomes of a community-based, mobile HIV-care, peer-delivered linkage case-management program (CommLink) implemented in Manzini region, Eswatini. Abstraction teams visited referral facilities during July 2019-April 2020 to locate, match, and abstract the clinical data of CommLink clients diagnosed between March 2016 and March 2018. An ingredients-based costing approach was used to assess economic costs associated with CommLink. The estimated total CommLink costs were $2 million. Personnel costs were the dominant component, followed by travel, commodities and supplies, and training. Costs per client tested positive were $499. Costs per client initiated on ART within 7, 30, and 90 days of diagnosis were $2114, $1634, and $1480, respectively. Costs per client initiated and retained on ART 6, 12, and 18 months after diagnosis were $2343, $2378, and $2462, respectively. CommLink outcomes and costs can help inform community-based HIV testing, linkage, and retention programs in other settings to strengthen effectiveness and improve efficiency.
抗逆转录病毒疗法 (ART) 的成功需要持续参与护理和达到最佳的依从水平,以实现持续的 HIV 病毒抑制。我们评估了在斯威士兰曼齐尼地区实施的基于社区、移动的 HIV 护理、同伴提供的链接病例管理计划 (CommLink) 的 HIV 护理级联成本和结果。在 2019 年 7 月至 2020 年 4 月期间,抽象团队访问了转介机构,以查找、匹配和抽象 CommLink 客户的临床数据,这些客户是在 2016 年 3 月至 2018 年 3 月期间诊断的。采用基于成分的成本核算方法来评估与 CommLink 相关的经济成本。估计的 CommLink 总成本为 200 万美元。人员成本是主要组成部分,其次是差旅、商品和供应品以及培训。每个检测呈阳性的客户的成本为 499 美元。每个在诊断后 7、30 和 90 天内开始接受 ART 的客户的成本分别为 2114 美元、1634 美元和 1480 美元。每个在诊断后 6、12 和 18 个月开始并保留在 ART 上的客户的成本分别为 2343 美元、2378 美元和 2462 美元。CommLink 的结果和成本可以帮助在其他环境中为基于社区的 HIV 检测、链接和保留计划提供信息,以提高有效性和提高效率。
Int J Environ Res Public Health. 2022-12-20
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