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Table 4 Descriptive overview of interventions

From: Costs of implementing community-based intervention for HIV testing in sub-Saharan Africa: a systematic review

Reference

Intervention description

Geographical setting

HIV prevalence

Population

Sample size

Time horizon

Data collection type

Perspective

Cost measurement

Sensitivity Analysis

Discount rate

Analysis Instrument

QHES Score

Intervention

Control(s)

HIVST

Choko et al. 2019 [97]

1. Standard of care + clinic access to HIVST [ST].

2. ST + $3 conditional fixed cash financial incentive [ST + $3].

3. ST + fixed cash financial incentive [ST + $10].

4. ST+ 10% chance of winning $30 [ST + lottery].

5. ST + phone reminder to present at clinic [ST + reminder]

Standard of care [SOC]

Blantyre, Malawi

Not stated

Women attending an antenatal care (ANC} for the first time for their current pregnancy (regardless of trimester), 18 years and older, with a primary male partner not known to be on ART

2349 pregnant women

8 August 2016 and 30 June 2017

Prospective

Healthcare only

Costs per male partner who attended the clinic with a confirmed HIV test result

None

 

None

52

George et al, 2018 [98]

Short message service (SMS) promoting availability of HIVST, sent once a week for 3 weeks [HIVST].

1. Standard of care (SMS reminder sent once. [SOC]

2. Enhanced standard of case (SMS reminder sent once a week for 3 weeks [Enhanced SOC].

Kenya

Not stated

Male truckers (Trucker) and female sex workers (FSW)

2262 truckers and 2196 FSWs

Dec. 2016 to April 2017

Prospective

Societal

(1) Total cost of cohort. (2) Total cost of intervention. (3) Cost per client. (4) Cost per additional client.

Univariate (cost sensitivity)

3%

Not stated

85.5

Maheswaran et al., 2016 [99]

Intervention:

HIVST

Control:

Facility-based HIV testing and counseling (FBHTC) in the following sites,

1. Queen Elizabeth Central Hospital [QECH]

2. Ndirande health center [Ndirande] Chilomani health center [Chilomani].

Blantyre, Malawi

18% (adult)

Adult

1,200 adults

Feb. 2013 to April 2014

Prospective

Societal

(1) Total annual health provider cost. (2) Cost per participant tested. (3) Cost per HIV positive identified. (4) Cost per HIV positive individual assessed for ART eligibility. (5) Cost per HIV positive initiated onto ART. (6) quality-adjusted life-year (QALY)

EuroQol EQ-5D (impact of alternative approaches to estimating total societal costs and for valuing health-related quality of life [HRQoL])

None

Non-parametric bootstrap methods and Generalized linear models (GLM) for multivariate analyses of cost data (stewed cost data).

86

Home-Based HIV counseling and testing

Bogart et al. 2017 [95]

Home-based HIV testing and counseling [HBHTC]

Event-based testing and counseling [EBHTC]

Lake Victoria, Uganda

Not stated

Adult 18 years and above. Children under 12 years old with consent. Infant 18 months and younger, with HIV+ mothers and mothers’ consent.

1363 individuals in 629 households (965 adults, 386 children; 13 missing ages)

May–July, 2015

Prospective

Healthcare only

(1) Total cost of each intervention (2) cost per test

None

None

Not stated

59

Cham et al. 2019 [96]

Home-based HIV testing and counseling [HBHTC]

1. Provider-initiated testing and counseling [PITC].

2. Venue-based HIV testing and counseling [VBHTC].

Bukoba Municipal Council (BMC), Tanzania

9.1% for adults aged 18–49 years (BMC)

People aged 15 years and older

133,695 people (56 304 males, 77 391 females).

2014–2017

Retrospective

Healthcare only

Estimated incremental cost over 2.5 years:

(1) Total intervention cost (2) Total cost of testing

Strategies. (3) Cost per test. (4) Cost per HIV diagnosed.

None

None

Not stated

76.0

Mulogo et al. 2013 [101]

Home-based HIV testing and counseling [HBHTC].

Facility-based HIV testing and counseling [FBHTC]

Rugando and Kabingo sub-Counties of Uganda

FBVCT = 7%

HBVCT = 9%

1 adult per household between ages 18-59. Total number of participants = 971; 294 males and 677 females.

418,300

(Rugando) and 385,500 (Kabingo)

Nov. 2007 to March 2008

Prospective

Healthcare only

(1) Total annual economic cost. (2) Average cost per client counseled and tested. (3) Average cost per client diagnosed HIV positive

Univariate (HIV prevalence likely to change over time)

5%

TreeAge Pro 2009

79.5

Tabana et al. 2015 [104]

Home-based HIV testing and counseling [HBHTC].

Facility-based HIV testing and counseling [FBHTC]

KwaZulu Natal, South Africa

17%

Adults 18 years and above, individuals 14–17-year-old with guardian/parental consent)

100 to 200 households, approx. 46,000 people

Jan. to Dec. 2010

Retrospective

Healthcare only

(1) Total annual cost. (2) Cost per client tested. (3) Incremental cost per additional HIV test

Univariate (professional nurses’ salaries, catchment population size, HIV test kits)

3– 6%

CostIt software 2007

78.5

Meehan et al. 2017 [100]

Mobile-based HIV testing and counseling (MHTC)

Stand-alone community-based HIV testing and counseling [SAHTC].

Cape Metro district, Western Cape Province, South Africa.

Antenatal HIV prevalence of 20.4%

Not stated

5031 individuals (SAHTC) and 3104 (MHTC)

July to Sept. 2014

Retrospective

Healthcare only

(1) Total cost of each HTS modality. (2) Costs per persons counseled. (3) Costs per test. (4) Costs per diagnosis. (5)K Costs per HIV referred. (6) Costs per linked to HIV care.

None

None

Not stated

67.0

Mobile HIV counseling and testing

Parker et al. 2015 [103]

Mobile-based testing and counseling (MHTC)

Home-based HIV testing and counseling [HBHTC].

Shiselweni region, Swaziland

Not stated

Individuals over 12 years of age who gave informed consent and deemed competent to make this decision. Individuals under 12, or lacking competence with legal guardian consent.

25 health facilities. 2043 (MHTC) and 12269 (HBHTC).

March - October, 2013

Not stated

Healthcare only

(1) Cost per person reached. (2) Cost per HIV positive identified. (3) Cost per HIV positive identified and linked to care.

None

None

Not stated

64.0

Provider-initiated counseling and testing

Obure et al. 2012 [102]

Provider-initiated counseling and testing [PITC]

Voluntary counseling and testing [VCT].

Kenya and Swaziland

7.1% -Kenya

26%-Swaziland

Not stated

41 health facilities in Kenya and Swaziland

2008–2009 fiscal year

Retrospective

Healthcare only

(1) Total annual cost. (2) Average cost per client counseled and tested. (3) Average cost per client diagnosed HIV positive

None

3%

Not stated

45.5