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Cost and Cost-Effectiveness of Distributing HIV Self-Tests within Assisted Partner Services in Western Kenya.

作者信息

Mudhune Victor, Sharma Monisha, Masyuko Sarah, Ngure Kenneth, Otieno George, Roy Paladhi Unmesha, Katz David A, Kariithi Edward, Farquhar Carey, Bosire Rose

机构信息

Centre for Global Health Research, Kenya Medical Research Institute, Kisumu P.O. Box 1578-40100, Kenya.

School of Public Health, Jomo Kenyatta University of Agriculture and Technology, Nairobi P.O. Box 62000-00200, Kenya.

出版信息

Healthcare (Basel). 2024 Sep 25;12(19):1918. doi: 10.3390/healthcare12191918.


DOI:10.3390/healthcare12191918
PMID:39408099
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11475082/
Abstract

Assisted partner services (APS) is a recommended public health approach to promote HIV testing for sexual partners of individuals diagnosed with HIV. We evaluated the cost and cost-effectiveness of integrating oral HIV self-testing (HIVST) into existing APS programs. Within the APS-HIVST study conducted in western Kenya (2021-2022), we conducted micro-costing, time-and-motion, and provider surveys to determine incremental HIVST distribution cost (2022 USD). Using a decision tree model, we estimated the incremental cost per new diagnosis (ICND) for HIVST incorporated into APS, compared to APS with provider-delivered testing only. Scenario, parameter and probabilistic sensitivity analyses were conducted to explore influential assumptions. The cost per HIVST distributed within APS was USD 8.97, largest component costs were testing supplies (38%) and personnel (30%). Under conditions of a facility-based testing uptake of <91%, or HIVST utilization rates of <27%, HIVST integration into APS is potentially cost-effective. At a willing-to-pay threshold of USD 1000, the net monetary benefit was sensitive to the effectiveness of HIVST in increasing testing rates, phone call rates, HIVST sensitivity, HIV prevalence, cost of HIVST, space allocation at facilities, and personnel time during facility-based testing. In a best-case scenario, the HIVST option was cheaper by USD 3037 and diagnosed 11 more cases (ICND = 265.82). Implementers and policy makers should ensure that HIVST programs are implemented under conditions that guarantee efficiency by focusing on facilities with low uptake for provider-delivered facility-based testing, while deliberately targeting HIVST utilization among the few likely to benefit from remote testing. Additional measures should focus on minimizing costs relating to personnel and testing supplies.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b6e0/11475082/a2af1f293ced/healthcare-12-01918-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b6e0/11475082/ca2eea50dadf/healthcare-12-01918-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b6e0/11475082/9d305f26c01f/healthcare-12-01918-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b6e0/11475082/a2af1f293ced/healthcare-12-01918-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b6e0/11475082/ca2eea50dadf/healthcare-12-01918-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b6e0/11475082/9d305f26c01f/healthcare-12-01918-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b6e0/11475082/a2af1f293ced/healthcare-12-01918-g004.jpg

相似文献

[1]
Cost and Cost-Effectiveness of Distributing HIV Self-Tests within Assisted Partner Services in Western Kenya.

Healthcare (Basel). 2024-9-25

[2]
Effectiveness of HIV self-testing when offered within assisted partner services in Western Kenya (APS-HIVST Study): a cluster randomized controlled trial.

J Int AIDS Soc. 2024-7

[3]
Cost of integrating assisted partner services in HIV testing services in Kisumu and Homa Bay counties, Kenya: a microcosting study.

BMC Health Serv Res. 2022-1-14

[4]
Uptake and acceptability of oral HIV self-testing in the context of assisted partner services in Western Kenya: A mixed-methods analysis.

PLOS Glob Public Health. 2024-11-15

[5]
Costing analysis of an SMS-based intervention to promote HIV self-testing amongst truckers and sex workers in Kenya.

PLoS One. 2018-7-6

[6]
The economic costs and cost-effectiveness of HIV self-testing among truck drivers in Kenya.

Health Policy Plan. 2024-4-10

[7]
Cost-effectiveness analysis of community-led HIV self-testing among key populations in Côte d'Ivoire, Mali, and Senegal.

J Int AIDS Soc. 2024-7

[8]
Economic Analysis of Low Volume Interventions Using Real-World Data: Costs of HIV Self-Testing Distribution and HIV Testing Services in West Africa From the ATLAS Project.

Front Health Serv. 2022-6-27

[9]
A community-based organisation-led HIV self-testing program among men who have sex with men in China is cheaper and more effective than facility-based HIV testing: an economic evaluation.

Sex Health. 2022-10

[10]
Using Assisted Partner Services for HIV Testing and the Treatment of Males and Their Female Sexual Partners: Protocol for an Implementation Science Study.

JMIR Res Protoc. 2021-5-20

本文引用的文献

[1]
Effectiveness of HIV self-testing when offered within assisted partner services in Western Kenya (APS-HIVST Study): a cluster randomized controlled trial.

J Int AIDS Soc. 2024-7

[2]
Cost-Effectiveness of HIV Screening in Emergency Departments: Results From the Pragmatic Randomized HIV Testing Using Enhanced Screening Techniques in Emergency Departments Trial.

Ann Emerg Med. 2024-9

[3]
For African Countries, the End of PEPFAR Shouldn't Be Unthinkable; It is Inevitable.

J Pediatric Infect Dis Soc. 2024-1-29

[4]
How much does HIV self-testing cost in low and middle income countries? A systematic review of evidence from economic studies.

Front Public Health. 2023

[5]
The Implementation of HIV Self-Testing in Resource-Limited Settings Where the HIV Disease Burden is High.

Int J Public Health. 2023

[6]
Economic Analysis of Low Volume Interventions Using Real-World Data: Costs of HIV Self-Testing Distribution and HIV Testing Services in West Africa From the ATLAS Project.

Front Health Serv. 2022-6-27

[7]
Scale-up of HIV index testing in an urban population: Experiences and achievements from Nairobi County, Kenya.

Trop Med Int Health. 2023-2

[8]
Sensitivity and specificity of OraQuick® HIV self-test compared to a 4th generation laboratory reference standard algorithm in urban and rural Zambia.

BMC Infect Dis. 2022-5-25

[9]
Consolidated Health Economic Evaluation Reporting Standards 2022 (CHEERS 2022) statement: updated reporting guidance for health economic evaluations.

MDM Policy Pract. 2022-1-11

[10]
A Systematic Review and Network Meta-analyses to Assess the Effectiveness of Human Immunodeficiency Virus (HIV) Self-testing Distribution Strategies.

Clin Infect Dis. 2021-8-16

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