Increasing access to HIV counseling and testing through mobile services in Kenya: strategies, utilization, and cost-effectiveness.
Increasing access to HIV counseling and testing through mobile services in Kenya: strategies, utilization, and cost-effectiveness.
复制标题
DOI：
10.1097/qai.0b013e3181ced126
复制
发表时间：
2010-07
期刊：
影响因子：
--
通讯作者：
Marum E
中科院分区：
文献类型：
--
作者：
Grabbe KL;Menzies N;Taegtmeyer M;Emukule G;Angala P;Mwega I;Musango G;Marum E
本研究将三种“移动”艾滋病毒咨询和检测 (HCT) 方法与肯尼亚现有的“独立”HCT 方法的客户数量、人口统计、检测结果和成本进行了比较。对 2005 年 5 月至 2006 年 4 月期间接受 HCT 的 62,173 名个体进行回顾性队列分析。评估的移动 HCT 方法包括社区现场移动 HCT、半移动集装箱 HCT 和全移动卡车 HCT。数据来自项目监测数据、项目账目和人员访谈。移动 HCT 报告的未进行 HIV 检测的客户比例高于独立检测（88% 比 58%）。独立 HCT 报告的夫妻比例高于移动 HCT（18% vs. 2%），并且不一致夫妻的比例也较高（12% vs. 4%）。将移动 HCT 添加到独立服务中的增量成本效益为每个测试客户 14.91 美元（而独立 HCT 为 26.75 美元）；每个之前未经测试的客户端 16.58 美元（而独立 HCT 为 43.69 美元）；每个确定的 HIV 阳性个体为 157.21 美元（而单独的 HCT 为 189.14 美元）。在现有的独立 HCT 中添加移动 HCT 似乎是一种具有成本效益的方法，可扩大 HCT 覆盖范围，覆盖包括妇女和年轻人在内的不同目标人群，并识别新诊断出的艾滋病毒感染者以转诊治疗和护理。
This study compares client volume, demographics, testing results and costs of three ‘mobile’ HIV counseling and testing (HCT) approaches with existing ‘stand-alone’ HCT in Kenya. A retrospective cohort of 62,173 individuals receiving HCT between May 2005 and April 2006, was analyzed. Mobile HCT approaches assessed were community-site mobile HCT, semi-mobile container HCT, and fully mobile truck HCT. Data were obtained from project monitoring data, project accounts and personnel interviews. Mobile HCT reported a higher proportion of clients with no prior HIV test than stand-alone (88% vs. 58%). Stand-alone HCT reported a higher proportion of couples than mobile HCT (18% vs. 2%), and a higher proportion of discordant couples (12% vs. 4%). The incremental cost-effectiveness of adding mobile HCT to stand-alone services was $14.91 per client tested (vs. $26.75 for stand-alone HCT); $16.58 per previously untested client (vs. $43.69 for stand-alone HCT); and $157.21 per HIV-positive individual identified (vs. $189.14 for stand-alone HCT). Adding mobile HCT to existing stand-alone HCT appears to be a cost-effective approach for expanding HCT coverage, for reaching different target populations, including women and young people, and for identifying persons with newly diagnosed HIV infection for referral to treatment and care.