Cost-outcome analysis of HIV testing and counseling, linkage, and defaulter tracing services in Bukoba, Tanzania

Details

• Alternative Title:
  AIDS Care
• Personal Author:
  Suraratdecha, Chutima ; MacKellar, Duncan ; Steiner, Claire ; Rwabiyago, Oscar Ernest ; Cham, Haddi Jatou ; Msumi, Omari ; Maruyama, Haruka ; Kundi, Gerald ; Byrd, Johnita ; Weber, Rachel ; Mkemwa, Grace ; Kazaura, Kokuhumbya ; Justman, Jessica ; Rwebembera, Anath
• Description:
  Effective services along the HIV continuum of care from HIV testing and counseling to linkage, and from linkage to antiretroviral therapy (ART) initiation and retention, are key to improved health outcomes of persons living with HIV. A comprehensive analysis of the costs and outcomes of cascade services is needed to help allocate and prioritize resources to achieve UNAIDS targets. We evaluated the costs and population-level impact of a community-wide, integrated scale-up of testing, linkage, and defaulter-tracing programs implemented in Bukoba Municipal Council, Tanzania. Costs per identified HIV-positive client for provider-initiated, and home- and venue-based testing and counseling were $92.64 United States dollars (USD), $256.33 USD, and $281.57 USD, respectively. Costs per patient linked to HIV care and ART were $47.69 USD and $74.12 USD, respectively, during all ART-eligibility periods combined. Costs per defaulter traced and returned to HIV care were $47.56 USD and $206.77 USD, respectively. The provider-initiated testing and counseling was the most cost-effective modality. Testing approaches targeted to populations groups and geographic location with high testing positivity rates may improve the overall efficiency of testing services. The expansion of ART eligibility criteria and high linkage rate also result in efficiency gains and economies of scale of linkage services.
• Subjects:
  Adult Continuity Of Patient Care Cost-Benefit Analysis Counseling Female HIV Infections HIV Testing Humans Male Mass Screening Tanzania

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• Keywords:
  Cost-outcome Defaulter-tracing HIV Testing And Counseling Linkage To Care
• Source:
  AIDS Care. 36(6):744-751
• Pubmed ID:
  37607238
• Pubmed Central ID:
  PMC10881889
• Document Type:
  Journal Article
• Funding:
  U2G PS001998/PS/NCHHSTP CDC HHSUnited States/
• Volume:
  36
• Issue:
  6
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:6fd5a438e54ee58328c8e7a83468c4719840b07aba446181d2dd129e2e5e9190a7922fcb05992566d56b71193580c47b901b60acf55c9236c6b3af069be43d02
• Download URL:
  https://stacks.cdc.gov/view/cdc/150312/cdc_150312_DS1.pdf
• File Type:
  [PDF - 348.37 KB ]