Cost of Home-Based Couples Human Immunodeficiency Virus Counseling and Testing and Human Immunodeficiency Virus Self-Testing During Pregnancy and Postpartum in Southwestern Kenya

被引:1
作者
Borgstede, Seth J. [1 ]
Elly, Assurah [2 ]
Helova, Anna [1 ,3 ]
Kwena, Zachary [2 ]
Darbes, Lynae A. [4 ,5 ]
Hatcher, Abigail [6 ]
Thirumurthy, Harsha [7 ]
Owino, George [2 ]
Pisu, Maria [8 ]
Owuor, Kevin [9 ]
Braun, Thomas [10 ]
Turan, Janet M. [1 ,3 ]
Bukusi, Elizabeth A. [2 ]
Nghiem, Van T. [1 ]
机构
[1] Univ Alabama Birmingham, Sch Publ Hlth, Dept Hlth Policy & Org, 1665 Univ Blvd,Ste RPHB 320F, Birmingham, AL 35233 USA
[2] Kenya Govt Med Res Ctr, Ctr Microbiol Res, Res Care & Treatment Programme, Nairobi, Kenya
[3] Univ Alabama Birmingham, Sparkman Ctr Global Hlth, Sch Publ Hlth, Birmingham, AL USA
[4] Univ Michigan, Ctr Sexual & Hlth Dispar, Sch Nursing, Ann Arbor, MI USA
[5] Univ Michigan, Sch Nursing, Dept Hlth Behav & Biol Sci, Ann Arbor, MI USA
[6] Univ N Carolina, Gillings Sch Global Publ Hlth, Dept Hlth Behav, Chapel Hill, NC USA
[7] Univ Penn, Perelman Sch Med, Dept Med Eth & Hlth Policy, Philadelphia, PA USA
[8] Univ Alabama Birmingham, Heersink Sch Med, Dept Prevent Med, Birmingham, AL USA
[9] Univ Alabama Birmingham, Sch Publ Hlth, Dept Biostat, Birmingham, AL USA
[10] Univ Michigan, Sch Publ Hlth, Dept Biostat, Ann Arbor, MI USA
基金
美国国家卫生研究院;
关键词
counseling; couples therapy; HIV testing; HIV; home care services; Kenya; costs; mother-to-child transmission; self-testing; HIV TRANSMISSION; PREVENTION; TIME; INTERVENTIONS;
D O I
10.1016/j.vhri.2022.11.003
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Objective: Home-based couples HIV testing and counseling and HIV self-testing (HIVST) for pregnant women can promote HIV status disclosure and male partner testing; however, cost data are lacking. We examined a home-based couples intervention (HBCI) and HIVST intervention costs per couple (unit cost) during pregnancy and postpartum in Kenya.Methods: This randomized controlled trial is comparing HBCI and HIVST for couples among pregnant women attending antenatal care clinics in two counties in southwestern Kenya. We used micro-costing to estimate the unit cost per couple receiving the intervention as the total of direct and indirect costs for each study arm in 2019 US$. We used a one-month window to conduct a time and motion study to determine personnel effort and resources. We then compared the unit cost by arm, identified key cost drivers, and conducted sensitivity analyses for cost uncertainties.Results: At base-case, the unit cost was $129.01 and $41.99, respectively, for HBCI and HIVST. Personnel comprised half of the unit cost for both arms. Staff spent more time on activities related to participant engagement in HBCI (accounting for 6.4% of the unit cost) than in HIVST (2.3%). Staff training was another key cost driver in HBCI (20.1% of the unit cost compared to 12.5% in HIVST). Sensitivity analyses revealed that the unit cost ranges were $104.64-$154.54 for HBCI and $30.49-$56.59 for HIVST.Conclusions: Our findings may guide spending decisions for future HIV prevention and treatment programs for pregnant couples in resource-limited settings such as Kenya.
引用
收藏
页码:125 / 132
页数:8
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