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

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Title: Cost-outcome analysis of HIV testing and counseling, linkage, and defaulter tracing services in Bukoba, Tanzania.
Authors: 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
Source: AIDS Care. Jun2024, Vol. 36 Issue 6, p744-751. 8p.
Subjects: HIV prevention, Cost effectiveness, Research funding, HIV infections, Continuum of care, Descriptive statistics, Highly active antiretroviral therapy, Medical screening, Counseling
Geographic Terms: United States, Tanzania
Abstract: 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. [ABSTRACT FROM AUTHOR]
Copyright of AIDS Care is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Label: Title
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  Data: Cost-outcome analysis of HIV testing and counseling, linkage, and defaulter tracing services in Bukoba, Tanzania.
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  Data: <searchLink fieldCode="AR" term="%22Suraratdecha%2C+Chutima%22">Suraratdecha, Chutima</searchLink><br /><searchLink fieldCode="AR" term="%22MacKellar%2C+Duncan%22">MacKellar, Duncan</searchLink><br /><searchLink fieldCode="AR" term="%22Steiner%2C+Claire%22">Steiner, Claire</searchLink><br /><searchLink fieldCode="AR" term="%22Rwabiyago%2C+Oscar+Ernest%22">Rwabiyago, Oscar Ernest</searchLink><br /><searchLink fieldCode="AR" term="%22Cham%2C+Haddi+Jatou%22">Cham, Haddi Jatou</searchLink><br /><searchLink fieldCode="AR" term="%22Msumi%2C+Omari%22">Msumi, Omari</searchLink><br /><searchLink fieldCode="AR" term="%22Maruyama%2C+Haruka%22">Maruyama, Haruka</searchLink><br /><searchLink fieldCode="AR" term="%22Kundi%2C+Gerald%22">Kundi, Gerald</searchLink><br /><searchLink fieldCode="AR" term="%22Byrd%2C+Johnita%22">Byrd, Johnita</searchLink><br /><searchLink fieldCode="AR" term="%22Weber%2C+Rachel%22">Weber, Rachel</searchLink><br /><searchLink fieldCode="AR" term="%22Mkemwa%2C+Grace%22">Mkemwa, Grace</searchLink><br /><searchLink fieldCode="AR" term="%22Kazaura%2C+Kokuhumbya%22">Kazaura, Kokuhumbya</searchLink><br /><searchLink fieldCode="AR" term="%22Justman%2C+Jessica%22">Justman, Jessica</searchLink><br /><searchLink fieldCode="AR" term="%22Rwebembera%2C+Anath%22">Rwebembera, Anath</searchLink>
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  Data: <searchLink fieldCode="JN" term="%22AIDS+Care%22">AIDS Care</searchLink>. Jun2024, Vol. 36 Issue 6, p744-751. 8p.
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  Data: 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. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
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  Data: <i>Copyright of AIDS Care is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1080/09540121.2023.2247959
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      – Code: eng
        Text: English
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      Pagination:
        PageCount: 8
        StartPage: 744
    Subjects:
      – SubjectFull: HIV prevention
        Type: general
      – SubjectFull: Cost effectiveness
        Type: general
      – SubjectFull: Research funding
        Type: general
      – SubjectFull: HIV infections
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      – SubjectFull: Continuum of care
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      – SubjectFull: Descriptive statistics
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      – SubjectFull: Highly active antiretroviral therapy
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      – SubjectFull: Medical screening
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      – SubjectFull: United States
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      – SubjectFull: Tanzania
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              Text: Jun2024
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              Y: 2024
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