Costing analysis of an SMS-based intervention to promote HIV self-testing amongst truckers and sex workers in Kenya.
Costing analysis of an SMS-based intervention to promote HIV self-testing amongst truckers and sex workers in Kenya.
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DOI：
10.1371/journal.pone.0197305
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发表时间：
2018
期刊：
影响因子：
3.7
通讯作者：
Kelvin EA
中科院分区：
文献类型：
--
作者：
George G;Chetty T;Strauss M;Inoti S;Kinyanjui S;Mwai E;Romo ML;Oruko F;Odhiambo JO;Nyaga E;Mantell JE;Govender K;Kelvin EA
许多撒哈拉以南非洲国家的艾滋病毒检测率仍不理想，迫切需要探索具有战略性但成本效益高的办法，以增加艾滋病毒检测的接受率，特别是在高危人群中。对在北星星联盟的电子健康记录系统（EHRS）中注册的男性卡车司机和女性性工作者（FSW）进行了随机对照试验（RCT）的成本分析，该联盟在南部和东部非洲的主要交通枢纽提供医疗保健服务。随机对照试验选择了一个样本的卡车司机和FSW谁是不规则的艾滋病毒测试，根据EHRS，并评估的影响SMS促进艾滋病毒自我检测（HIVST）试剂盒的可用性在肯尼亚诊所（干预方案）与一般SMS提醒客户检测艾滋病毒（增强和标准程序）对艾滋病毒检测率。在本文中，我们从供应商的角度计算成本，使用混合方法来识别，测量和评估干预和标准计划中使用的资源。分析结果反映了每个受测客户的成本。据计算，提供艾滋病毒/艾滋病检测的费用是常规设施检测费用的两倍（每名受检者10.13美元对5.01美元），这主要是由于自我检测包的价格很高。在仅在诊所提供者管理的HIV检测的两个研究组中，只有1%的卡车司机和6%的FSW在研究期间进行了检测，而在也提供HST的干预组中，大约4%的卡车司机和11%的FSW进行了检测。这些低于预期的结果导致所有三个研究组的每名客户成本估计相对较高。在干预组中，65%的卡车司机和72%的FSW选择了HIVST选项。然而，在干预组内，女性性工作者每增加一名接受测试的客户的成本低于卡车司机，每增加一名接受测试的客户的成本为0.15美元，而每增加一名接受测试的客户的成本为0.58美元，这主要是由于应答率较高。虽然提供艾滋病毒/艾滋病检测服务增加了卡车司机和性工作者的艾滋病毒检测，但提供艾滋病毒/艾滋病检测服务的成本高于常规卫生设施检测的成本，主要是由于艾滋病毒自我检测试剂盒的价格。未来的研究需要确定的策略，增加对艾滋病毒的需求，并确定这些策略和随后增加的需求艾滋病毒的成本效益相对于传统的设施为基础的测试目前可用。
HIV testing rates in many sub-Saharan African countries have remained suboptimal, and there is an urgent need to explore strategic yet cost-effective approaches to increase the uptake of HIV testing, especially among high-risk populations. A costing analysis was conducted for a randomized controlled trial (RCT) with male truckers and female sex workers (FSWs) registered in the electronic health record system (EHRS) of the North Star Alliance, which offers healthcare services at major transit hubs in Southern and East Africa. The RCT selected a sample of truckers and FSWs who were irregular HIV testers, according to the EHRS, and evaluated the effect of SMSs promoting the availability of HIV self-testing (HIVST) kits in Kenyan clinics (intervention program) versus a general SMS reminding clients to test for HIV (enhanced and standard program) on HIV testing rates. In this paper, we calculated costs from a provider perspective using a mixed-methods approach to identify, measure, and value the resources utilized within the intervention and standard programs. The results of the analysis reflect the cost per client tested. The cost of offering HIVST was calculated to be double that of routine facility-based testing (USD 10.13 versus USD 5.01 per client tested), primarily due to the high price of the self-test kit. In the two study arms that only offered provider-administered HIV testing in the clinic, only 1% of truckers and 6% of FSWs tested during the study period, while in the intervention arm, which also offered HST, approximately 4% of truckers and 11% of FSWs tested. These lower than expected outcomes resulted in relatively high cost per client estimates for all three study arms. Within the intervention arm, 65% of truckers and 72% of FSWs who tested chose the HIVST option. However, within the intervention arm, the cost per additional client tested was lower for FSWs than for truckers, at USD 0.15 per additional client tested versus USD 0.58 per additional client tested, driven primarily by the higher response rates. Whilst the availability of HIVST increased HIV testing among both truckers and FSWs, the cost of providing HIVST is higher than that of a routine health facility-based test, driven primarily by the price of the HIV self-test kit. Future research needs to identify strategies which increase demand for HIVST, and determine whether these strategies and the subsequent increased demand for HIVST are cost-effective in relation to the conventional facility based testing currently available.
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DOI：
10.1097/qai.0b013e3181ced126
发表时间：
2010-07
期刊：
Journal of acquired immune deficiency syndromes (1999)
影响因子：
--
作者：
Grabbe KL;Menzies N;Taegtmeyer M;Emukule G;Angala P;Mwega I;Musango G;Marum E
通讯作者：
Marum E
影响因子：
1.6
作者：
Patel AR;Kessler J;Braithwaite RS;Nucifora KA;Thirumurthy H;Zhou Q;Lester RT;Marra CA
通讯作者：
Marra CA
影响因子：
4.7
作者：
Conserve DF;Jennings L;Aguiar C;Shin G;Handler L;Maman S
通讯作者：
Maman S
影响因子：
3.8
作者：
Rakwar, J;Lavreys, L;Kreiss, L
通讯作者：
Kreiss, L
影响因子：
5.9
作者：
Azuonwu, Obioma;Erhabor, Osaro;Frank-Peterside, Nnenna
通讯作者：
Frank-Peterside, Nnenna