1. Costs of HIV testing services in sub-Saharan Africa: a systematic literature review.
- Author
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Ahmed N, Ong JJ, McGee K, d'Elbée M, Johnson C, Cambiano V, Hatzold K, Corbett EL, Terris-Prestholt F, and Maheswaran H
- Subjects
- Humans, Africa South of the Sahara, Female, Male, Self-Testing, Mass Screening economics, Mass Screening methods, Health Care Costs statistics & numerical data, HIV Infections diagnosis, HIV Infections economics, HIV Testing economics, HIV Testing methods
- Abstract
Objective: To review HIV testing services (HTS) costs in sub-Saharan Africa., Design: A systematic literature review of studies published from January 2006 to October 2020., Methods: We searched ten electronic databases for studies that reported estimates for cost per person tested ($pptested) and cost per HIV-positive person identified ($ppositive) in sub-Saharan Africa. We explored variations in incremental cost estimates by testing modality (health facility-based, home-based, mobile-service, self-testing, campaign-style, and stand-alone), by primary or secondary/index HTS, and by population (general population, people living with HIV, antenatal care male partner, antenatal care/postnatal women and key populations). All costs are presented in 2019US$., Results: Sixty-five studies reported 167 cost estimates. Most reported only $pptested (90%), while (10%) reported the $ppositive. Costs were highly skewed. The lowest mean $pptested was self-testing at $12.75 (median = $11.50); primary testing at $16.63 (median = $10.68); in the general population, $14.06 (median = $10.13). The highest costs were in campaign-style at $27.64 (median = $26.70), secondary/index testing at $27.52 (median = $15.85), and antenatal male partner at $47.94 (median = $55.19). Incremental $ppositive was lowest for home-based at $297.09 (median = $246.75); primary testing $352.31 (median = $157.03); in the general population, $262.89 (median: $140.13)., Conclusion: While many studies reported the incremental costs of different HIV testing modalities, few presented full costs. Although the $pptested estimates varied widely, the costs for stand-alone, health facility, home-based, and mobile services were comparable, while substantially higher for campaign-style HTS and the lowest for HIV self-testing. Our review informs policymakers of the affordability of various HTS to ensure universal access to HIV testing., (© 2024. The Author(s).)
- Published
- 2024
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