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  5. 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
 
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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
File(s)
Costs and Scale-Up Costs of Integrating HIV Self-Testing Into Civil Society.pdf (1.12 MB)
Published version
Author(s)
d'Elbée, Marc
Traore, Métogara Mohamed
Badiane, Kéba
Vautier, Anthony
Simo Fotso, Arlette
more
Type
Journal Article
Abstract
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.
Date Issued
2021-05-24
Date Acceptance
2021-04-26
Citation
Frontiers in Public Health, 2021, 9
URI
http://hdl.handle.net/10044/1/89905
DOI
https://www.dx.doi.org/10.3389/fpubh.2021.653612
ISSN
2296-2565
Publisher
Frontiers Media
Journal / Book Title
Frontiers in Public Health
Volume
9
Copyright Statement
© 2021 d'Elbée, Traore, Badiane, Vautier, Simo Fotso, Kabemba, Rouveau, Godfrey-Faussett, Maheu-Giroux, Boily, Medley, Larmarange and Terris-Prestholt. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
License URL
Attribution 4.0 International
Sponsor
Solidarite Therapeutiq Initiative Sida
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/34109146
Grant Number
N/A
Subjects
HIV self-testing
West Africa
costs and cost analysis
diagnosis
key populations
knowledge of HIV status
scale-up
screening
COVID-19
Cote d'Ivoire
Female
HIV Infections
Homosexuality, Male
Humans
Male
Mali
Pandemics
SARS-CoV-2
Self-Testing
Senegal
Sex Workers
Sexual and Gender Minorities
Publication Status
Published
Coverage Spatial
Switzerland
Article Number
ARTN 653612
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