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Table 5 Intervention cost per outcome

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

Publication

Continuum of care costed

Total implementation cost

Cost per client

Intervention

Control

Intervention

Control

HIVST

Choko et al. 2019 [97]

Intervention: HIVSTa

Control: SOC

Testing and initiated ART treatment

Total intervention cost (excluding ART or VMMC):

1. STb = USD 3446.03

2. ST + $3 = USD 3678.44

3. ST + $10 = USD 7469.87

4. ST + lottery = USD 1175.64

5. ST + phone = USD 3 464.41

SOC = USD 557.40

1. Cost per male partner tested + attended male friendly clinics (MFC):

a. ST = USD 40.54

b. ST + $3 = USD 23.73

c. ST + $10 = USD 28.08

d. ST + lottery = USD 39.19

e. ST + phone = USD 41.24

2. Cost per male partner tested + ARTc/VMMCd:

a. ST = USD 127.63

b. ST + $3 = USD 94.32

c. ST + $10 = USD 109.85

d. ST + lottery = USD 167.95

e. ST + phone = USD 157.47

1. Cost per male partner tested + attended MFCe: SOCf = USD 9.95

2. Cost per male partner tested + ART/VMMC: SOC = USD 39.81

George et al. 2018 [98]

Intervention: HIVST

Controls: SOC and Enhanced SOC

Testing

Total intervention cost

• Trucker = USD 3678.44

• FSWg = USD 7469.87

1. Total cost per intervention (Trucker):

a. HIVST = USD 544.03

2. Total cost per intervention (FSW):

• HIVST = USD 925.55

1. Total intervention cost

• SOC = USD 284.81

• Enhanced SOC = USD 335.69

2. Total cost per intervention (FSW):

• SOC = USD 411.18

• Enhanced SOC = USD 473.04

1. Cost per client (Trucker):

• HIVST = USD 20.92

2. Cost per client (FSW):

• HIVST = USD 11.43

3. Cost per additional client tested (Trucker):

• HIVST = USD 21.48

4. Cost per additional client tested (FSW):

• HIVST = USD 15.80

1. Cost per client (Trucker):

• SOC = USD 28.48

• Enhanced SOC = USD 33.57

2. Cost per client (FSW):

• SOC = USD 9.56

• Enhanced SOC = USD 10.28

3. Cost per additional client tested (Trucker):

• SOC = USD 26.26

• Enhanced SOC = USD 30.80

4. Cost per additional client tested (FSW):

• SOC = USD 9.90

• Enhanced SOC = USD 10.63

Maheswaran et al. 2016 [99]

Intervention: HIVST

Control: FBHTCh

Testing, HIV diagnosis, and ART initiation

Total annual health provider cost: HIVST = USD 133 300

• Ndirande = USD 50 899

• Chilomani = USD 56 760

• QECHl = USD 84 436

1. Direct cost per individual tested: HIVST = USD 8.78

2. Direct cost per HIV positive identified: HIVST = USD 97.50

3. Direct cost per HIV positive individuals assessed for ART eligibility: HIVT Service = USD 165.14

4. Direct cost per HIV positive individuals initiated onto ART:

• HIVST = USD 319.67

1. Direct cost per individual tested:

• Ndirande = USD 7.53

• Chilomani = USD 10.57

• QECH = USD 8.90

2. Direct cost per HIV positive identified:

• Ndirande = USD 67.33

• Chilomani = USD 76.39

• QECH = USD 28.30

3. Direct cost per HIV positive individuals assessed for ART eligibility:

• Ndirande = USD 83.48

• Chilomani = USD 92.38

• QECH = USD 37.73

4. Direct cost per HIV positive individuals initiated onto ART:

• Ndirande = USD 109.85

• Chilomani = USD 132.42

QECH = USD 85.75

Home-based HIV counseling and testing

Bogart et al. 2017 [95]

Intervention: HBHTCj

Control: EBHTCk

Testing

HBHTC = USD 62 247

EBHTC = USD 25 780

HBHTC = USD 45.09

EBHTC = USD 46.99

Cham et al. 20191 [96]

Intervention: HBHTC

Controls: PITCl and VBHTCm

Testing and HIV diagnosis

1. Total intervention cost = USD 720 607.67

2. Total cost per intervention: HBHTC = USD 176 865.66

1. Cost per intervention

• PITC = USD 404 364.89

• VBHTC = USD 139 377.12

1. Cost per test: HBHTC = USD 6.45

2. Cost per new HIV diagnosed: HBHTC = USD 354.44

1. Cost per test:

• PITC = USD 4.55

• VBHTC = USD 7.98

2. Cost per new HIV diagnosed:

• PITC = USD 123.66

• VBHTC = USD 372.67

Mulogo et al., 20132 [101]

Intervention: HBHTC

Control: FBHTC

Testing and HIV diagnosis.

USD 3114

USD 2462

1. Cost per client tested: USD 5.0

2. Average cost per client diagnosed HIV positive: USD 1

1. Cost per client tested: USD 6.4

2. Average cost per client diagnosed HIV positive: USD 2

Tabana et al. 20153 [104]

Intervention: HBHTC

Control: FBHTC

Testing

USD 233 239.02

USD 146 615.12

USD 29

USD 38

Mobile HIV Counseling and Testing

Meehan et al. 2017 [100]

Intervention: MHTCn

Control: SAHTSo

Testing, HIV diagnosis, referral to treatment.

USD 77 764

USD 96 616

1. Cost per person counseled: USD 25

2. Cost per person test: USD 25

3. Cost per HIV diagnosed: USD 1051

4. Cost per HIV referred: USD 1065

5. Cost per linked to HIV care: USD 2102

1. Cost per person counseled: USD 50

2. Cost per person test: USD 51

3. Cost per HIV diagnosed: USD 755

4. Cost per HIV referred: USD 773

5. Cost per linked to HIV care: USD 1039

Parker et al. 2015 [103]

Intervention: MHTC

Control: HBHTC

Testing and HIV diagnosis.

  

1. Cost per person reached: USD 24

2. Cost per HIV positive identified: USD 543

3. Cost per HIV positive identified and linked to care: USD 1698

4. Cost per person reached: USD 11

5. Cost per HIV positive identified: USD 343

6. Cost per HIV positive identified and linked to care: USD 797

Provider-initiated counseling and testing

Obure et al. 2012 [102]

Intervention: PITC

Control: VCTp

Testing and HIV diagnosis.

Average annual economic cost

1. Kenya: USD 3 721

2. Swaziland: USD 10 407

Average annual economic cost

1. Kenya: USD 11 969

2. Swaziland: USD 16 716

1. Average cost per client:

• Kenya: USD 5.71

• Swaziland: USD 7.79

2. Average cost per client diagnosed HIV positive:

• Kenya: USD 46.96

• Swaziland: USD 47.85

1. Average cost per client:

• Kenya: USD 8.27

• Swaziland: USD 9.44

2. Average cost per client diagnosed HIV positive:

• Kenya: USD 110.32

• Swaziland: USD 45.56

  1. Estimated incremental cost over 2.5 years;
  2. 2ICER = 3.50
  3. 3ICER = 19
  4. aHIVST: HIV self-testing
  5. bST standard of care + access to HIVST
  6. cART antiretroviral therapy
  7. dVMMC voluntary medical male circumcision
  8. eMFC male friendly clinics
  9. fSOC standard of care
  10. gFSW female sex workers
  11. hFBHTC facility-based HIV testing and counseling
  12. iQECH Queen Elizabeth Central Hospital
  13. jHBHTC home-based HIV testing and counseling
  14. kEBHTC event-based HIV testing and counseling
  15. lPITC provider-initiated testing and counseling
  16. mVBHTC venue-based HIV testing and counseling
  17. nMHTC mobile-based HIV testing and counseling
  18. oSAHTS stand-alone community-based HIV testing and counseling
  19. pVCT voluntary counseling and testing