Assessment of the Potential Impact and Cost-effectiveness of Self-Testing for HIV in Low-Income Countries

The Journal of Infectious Diseases
Valentina CambianoAndrew Phillips

Abstract

Studies have demonstrated that self-testing for human immunodeficiency virus (HIV) is highly acceptable among individuals and could allow cost savings, compared with provider-delivered HIV testing and counseling (PHTC), although the longer-term population-level effects are uncertain. We evaluated the cost-effectiveness of introducing self-testing in 2015 over a 20-year time frame in a country such as Zimbabwe. The HIV synthesis model was used. Two scenarios were considered. In the reference scenario, self-testing is not available, and the rate of first-time and repeat PHTC is assumed to increase from 2015 onward, in line with past trends. In the intervention scenario, self-testing is introduced at a unit cost of $3. We predict that the introduction of self-testing would lead to modest savings in healthcare costs of $75 million, while averting around 7000 disability-adjusted life-years over 20 years. Findings were robust to most variations in assumptions; however, higher cost of self-testing, lower linkage to care for people whose diagnosis is a consequence of a positive self-test result, and lower threshold for antiretroviral therapy eligibility criteria could lead to situations in which self-testing is not cost-effective. This...Continue Reading

References

Jun 28, 2011·Annals of Emergency Medicine·Charlotte A GaydosRichard E Rothman
Mar 15, 2013·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Sue Napierala MavedzengeElizabeth L Corbett
May 25, 2013·The Journal of Infectious Diseases·Valentina CambianoAndrew Phillips
Jun 30, 2014·AIDS and Behavior·Samuel KalibalaPatricia Oluoch

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Citations

Feb 3, 2016·Current HIV/AIDS Reports·Margo M Jacobsen, Rochelle P Walensky
Jun 1, 2016·The Lancet. HIV·Cheryl C Johnson, Elizabeth L Corbett
Mar 15, 2015·The Journal of Infectious Diseases·Benjamin P Linas
Apr 2, 2016·The Journal of Infectious Diseases·Andrew N PhillipsTimothy B Hallett
Nov 4, 2015·Journal of the International Association of Providers of AIDS Care·UNKNOWN International Advisory Panel on HIV Care Continuum Optimization
Mar 26, 2019·Journal of the International AIDS Society·Collin MangenahFern Terris-Prestholt
Mar 26, 2019·Journal of the International AIDS Society·Valentina CambianoUNKNOWN for Working Group on Cost Effectiveness of HIV self-testing in Southern Africa
Dec 4, 2015·Nature·UNKNOWN Working Group on Modelling of Antiretroviral Therapy Monitoring Strategies in Sub-Saharan AfricaPaul Revill
Jul 23, 2019·Journal of the International AIDS Society·Frances M CowanAndrew N Phillips
Nov 30, 2019·African Journal of AIDS Research : AJAR·Catherine Barker CantelmoArin Dutta
Dec 2, 2017·AIDS·Yilu QinJoseph D Tucker
Apr 24, 2020·AIDS Patient Care and STDs·Kadija M TahlilJoseph D Tucker
Apr 3, 2019·BMJ : British Medical Journal·Michelle RemmePascale Allotey
Mar 23, 2020·AIDS and Behavior·Curtis DolezalAlex Carballo-Diéguez
Oct 20, 2020·Open Forum Infectious Diseases·Eneyi E KpokiriJoseph D Tucker
Mar 12, 2021·Health Policy and Planning·Rabiah Al AdawiyahVirginia Wiseman
Oct 14, 2021·BMC Health Services Research·Arthi VasantharoopanLorna Guinness
Nov 23, 2021·Philosophical Transactions. Series A, Mathematical, Physical, and Engineering Sciences·Fengshi JingWeiming Tang

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