Costs and Scale-Up Costs of Integrating HIV Self-Testing Into Civil Society Organisation-Led Programmes for Key Populations in Côte d'Ivoire, Senegal, and Mali
Despite significant progress on the proportion of individuals who know their HIV status in 2020, Côte d'Ivoire (76%), Senegal (78%), and Mali (48%) remain far below, and key populations (KP) including female sex workers (FSW), men who have sex with men (MSM), and people who use drugs (PWUD) are...
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Frontiers Media S.A.
2021-05-01
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2021.653612/full |
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| author | Marc d'Elbée Métogara Mohamed Traore Kéba Badiane Anthony Vautier Arlette Simo Fotso Odé Kanku Kabemba Nicolas Rouveau Peter Godfrey-Faussett Peter Godfrey-Faussett Mathieu Maheu-Giroux Marie-Claude Boily Graham Francis Medley Joseph Larmarange Fern Terris-Prestholt Fern Terris-Prestholt |
| author_facet | Marc d'Elbée Métogara Mohamed Traore Kéba Badiane Anthony Vautier Arlette Simo Fotso Odé Kanku Kabemba Nicolas Rouveau Peter Godfrey-Faussett Peter Godfrey-Faussett Mathieu Maheu-Giroux Marie-Claude Boily Graham Francis Medley Joseph Larmarange Fern Terris-Prestholt Fern Terris-Prestholt |
| author_sort | Marc d'Elbée |
| collection | DOAJ |
| description | Despite significant progress on the proportion of individuals who know their HIV status in 2020, Côte d'Ivoire (76%), Senegal (78%), and Mali (48%) remain far below, and key populations (KP) including female sex workers (FSW), men who have sex with men (MSM), and people who use drugs (PWUD) are the most vulnerable groups with a HIV prevalence at 5–30%. HIV self-testing (HIVST), a process where a person collects his/her own specimen, performs a test, and interprets the result, was introduced in 2019 as a new testing modality through the ATLAS project coordinated by the international partner organisation Solthis (IPO). We estimate the costs of implementing HIVST through 23 civil society organisations (CSO)-led models for KP in Côte d'Ivoire (N = 7), Senegal (N = 11), and Mali (N = 5). We modelled costs for programme transition (2021) and early scale-up (2022–2023). Between July 2019 and September 2020, a total of 51,028, 14,472, and 34,353 HIVST kits were distributed in Côte d'Ivoire, Senegal, and Mali, respectively. Across countries, 64–80% of HIVST kits were distributed to FSW, 20–31% to MSM, and 5–8% to PWUD. Average costs per HIVST kit distributed were $15 for FSW (Côte d'Ivoire: $13, Senegal: $17, Mali: $16), $23 for MSM (Côte d'Ivoire: $15, Senegal: $27, Mali: $28), and $80 for PWUD (Côte d'Ivoire: $16, Senegal: $144), driven by personnel costs (47–78% of total costs), and HIVST kits costs (2–20%). Average costs at scale-up were $11 for FSW (Côte d'Ivoire: $9, Senegal: $13, Mali: $10), $16 for MSM (Côte d'Ivoire: $9, Senegal: $23, Mali: $17), and $32 for PWUD (Côte d'Ivoire: $14, Senegal: $50). Cost reductions were mainly explained by the spreading of IPO costs over higher HIVST distribution volumes and progressive IPO withdrawal at scale-up. In all countries, CSO-led HIVST kit provision to KP showed relatively high costs during the study period related to the progressive integration of the programme to CSO activities and contextual challenges (COVID-19 pandemic, country safety concerns). In transition to scale-up and integration of the HIVST programme into CSO activities, this model shows large potential for substantial economies of scale. Further research will assess the overall cost-effectiveness of this model. |
| first_indexed | 2024-12-22T00:02:59Z |
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| language | English |
| last_indexed | 2024-12-22T00:02:59Z |
| publishDate | 2021-05-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Public Health |
| spelling | doaj.art-fb6db820e0a642b38fc4d85deac66cbd2022-12-21T18:45:38ZengFrontiers Media S.A.Frontiers in Public Health2296-25652021-05-01910.3389/fpubh.2021.653612653612Costs and Scale-Up Costs of Integrating HIV Self-Testing Into Civil Society Organisation-Led Programmes for Key Populations in Côte d'Ivoire, Senegal, and MaliMarc d'Elbée0Métogara Mohamed Traore1Kéba Badiane2Anthony Vautier3Arlette Simo Fotso4Odé Kanku Kabemba5Nicolas Rouveau6Peter Godfrey-Faussett7Peter Godfrey-Faussett8Mathieu Maheu-Giroux9Marie-Claude Boily10Graham Francis Medley11Joseph Larmarange12Fern Terris-Prestholt13Fern Terris-Prestholt14Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United KingdomSolthis, Abidjan, Côte d'IvoireSolthis, Dakar, SénégalSolthis, Dakar, SénégalCentre Population et Développement (Ceped UMR 196), Institut de Recherche pour le Développement (IRD), Université de Paris, Inserm (ERL 1244), Paris, FranceSolthis, Bamako, MaliCentre Population et Développement (Ceped UMR 196), Institut de Recherche pour le Développement (IRD), Université de Paris, Inserm (ERL 1244), Paris, FranceJoint United Nations Programme on HIV/AIDS (UNAIDS), Geneva, SwitzerlandClinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United KingdomDepartment of Epidemiology, Biostatistics, and Occupational Health, School of Population and Global Health, McGill University, Montréal, QC, CanadaDepartment of Infectious Disease Epidemiology, Medical Research Council Centre for Global Infectious Disease Analysis, Imperial College London, London, United KingdomDepartment of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United KingdomCentre Population et Développement (Ceped UMR 196), Institut de Recherche pour le Développement (IRD), Université de Paris, Inserm (ERL 1244), Paris, FranceDepartment of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United KingdomJoint United Nations Programme on HIV/AIDS (UNAIDS), Geneva, SwitzerlandDespite significant progress on the proportion of individuals who know their HIV status in 2020, Côte d'Ivoire (76%), Senegal (78%), and Mali (48%) remain far below, and key populations (KP) including female sex workers (FSW), men who have sex with men (MSM), and people who use drugs (PWUD) are the most vulnerable groups with a HIV prevalence at 5–30%. HIV self-testing (HIVST), a process where a person collects his/her own specimen, performs a test, and interprets the result, was introduced in 2019 as a new testing modality through the ATLAS project coordinated by the international partner organisation Solthis (IPO). We estimate the costs of implementing HIVST through 23 civil society organisations (CSO)-led models for KP in Côte d'Ivoire (N = 7), Senegal (N = 11), and Mali (N = 5). We modelled costs for programme transition (2021) and early scale-up (2022–2023). Between July 2019 and September 2020, a total of 51,028, 14,472, and 34,353 HIVST kits were distributed in Côte d'Ivoire, Senegal, and Mali, respectively. Across countries, 64–80% of HIVST kits were distributed to FSW, 20–31% to MSM, and 5–8% to PWUD. Average costs per HIVST kit distributed were $15 for FSW (Côte d'Ivoire: $13, Senegal: $17, Mali: $16), $23 for MSM (Côte d'Ivoire: $15, Senegal: $27, Mali: $28), and $80 for PWUD (Côte d'Ivoire: $16, Senegal: $144), driven by personnel costs (47–78% of total costs), and HIVST kits costs (2–20%). Average costs at scale-up were $11 for FSW (Côte d'Ivoire: $9, Senegal: $13, Mali: $10), $16 for MSM (Côte d'Ivoire: $9, Senegal: $23, Mali: $17), and $32 for PWUD (Côte d'Ivoire: $14, Senegal: $50). Cost reductions were mainly explained by the spreading of IPO costs over higher HIVST distribution volumes and progressive IPO withdrawal at scale-up. In all countries, CSO-led HIVST kit provision to KP showed relatively high costs during the study period related to the progressive integration of the programme to CSO activities and contextual challenges (COVID-19 pandemic, country safety concerns). In transition to scale-up and integration of the HIVST programme into CSO activities, this model shows large potential for substantial economies of scale. Further research will assess the overall cost-effectiveness of this model.https://www.frontiersin.org/articles/10.3389/fpubh.2021.653612/fullcosts and cost analysisscale-upHIV self-testingkey populationsknowledge of HIV statusdiagnosis |
| spellingShingle | Marc d'Elbée Métogara Mohamed Traore Kéba Badiane Anthony Vautier Arlette Simo Fotso Odé Kanku Kabemba Nicolas Rouveau Peter Godfrey-Faussett Peter Godfrey-Faussett Mathieu Maheu-Giroux Marie-Claude Boily Graham Francis Medley Joseph Larmarange Fern Terris-Prestholt Fern Terris-Prestholt Costs and Scale-Up Costs of Integrating HIV Self-Testing Into Civil Society Organisation-Led Programmes for Key Populations in Côte d'Ivoire, Senegal, and Mali Frontiers in Public Health costs and cost analysis scale-up HIV self-testing key populations knowledge of HIV status diagnosis |
| title | Costs and Scale-Up Costs of Integrating HIV Self-Testing Into Civil Society Organisation-Led Programmes for Key Populations in Côte d'Ivoire, Senegal, and Mali |
| title_full | Costs and Scale-Up Costs of Integrating HIV Self-Testing Into Civil Society Organisation-Led Programmes for Key Populations in Côte d'Ivoire, Senegal, and Mali |
| title_fullStr | Costs and Scale-Up Costs of Integrating HIV Self-Testing Into Civil Society Organisation-Led Programmes for Key Populations in Côte d'Ivoire, Senegal, and Mali |
| title_full_unstemmed | Costs and Scale-Up Costs of Integrating HIV Self-Testing Into Civil Society Organisation-Led Programmes for Key Populations in Côte d'Ivoire, Senegal, and Mali |
| title_short | Costs and Scale-Up Costs of Integrating HIV Self-Testing Into Civil Society Organisation-Led Programmes for Key Populations in Côte d'Ivoire, Senegal, and Mali |
| title_sort | costs and scale up costs of integrating hiv self testing into civil society organisation led programmes for key populations in cote d ivoire senegal and mali |
| topic | costs and cost analysis scale-up HIV self-testing key populations knowledge of HIV status diagnosis |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2021.653612/full |
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