Incremental costs of integrated PrEP provision and effective use counselling in community-based platforms for adolescent girls and young women in South Africa: an observational study.
Incremental costs of integrated PrEP provision and effective use counselling in community-based platforms for adolescent girls and young women in South Africa: an observational study.
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DOI：
10.1002/jia2.25875
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发表时间：
2022-03
影响因子：
6
通讯作者：
Peebles K
中科院分区：
文献类型：
--
作者：
Mudimu E;Sardinia J;Momin S;Medina-Marino A;Bezuidenhout C;Bekker LG;Barnabas RV;Peebles K
少女和年轻女性（AGYW）是暴露前预防（PrEP）的优先人群，这是一种非常有效的艾滋病毒预防方法。然而，AGYW中有效的PrEP使用率很低。支持PrEP有效使用的干预措施可能会改善服药情况。PrEP计划的可负担性取决于其成本。因此，我们评估了以社区为基础的PrEP与有效使用咨询的成本。来自随机对照试验的成本数据用于评估2018年11月至2019年11月期间通过社区艾滋病毒检测平台向AGYW提供有效使用咨询的PrEP提供成本。AGYW随机接受（1）基于团体的社区健康俱乐部有效使用咨询，（2）个性化有效使用咨询或（3）基于社区的PrEP药房。在第1组和第2组中实施了从护士到经过培训的非专业咨询人员的有效使用咨询任务转移。人员成本是根据时间和运动观察和工作人员访谈估计的。使用基于支出和成分的方法估计医疗和非医疗用品的成本。总共有603名AGYW启动了PrEP，并累积了总计1280个月的PrEP。在卫生署情景下，以小组为基础的社区健康俱乐部，个性化有效使用辅导和社区为基础的PrEP药房的PrEP每人每月的平均成本相似且较高（分别为55.32美元、55.65美元和55.46美元），原因是临床试验中观察到的PrEP客户量较低。增加客户数量（按比例缩放的卫生部场景）将每人每月的估计成本分别降低至15.48美元、26.40美元和13.99美元。根据设计，个性化有效使用咨询使标准护理PrEP交付的成本增加了89%，基于团体的社区健康有效使用咨询使标准护理PrEP交付的成本增加了11%。这些估计可以为PrEP提供有效使用咨询服务的成本效益和预算影响分析提供信息。
Adolescent girls and young women (AGYW) are a priority population for pre‐exposure prophylaxis (PrEP), a highly effective HIV prevention method. However, effective PrEP use among AGYW has been low. Interventions to support PrEP effective use may improve pill‐taking. Affordability of PrEP programs depends on their cost. We, therefore, evaluated the cost of community‐based PrEP with effective use counselling. Cost data from a randomized controlled trial were used to evaluate the cost of PrEP provision with effective use counselling offered to AGYW through community‐based HIV testing platforms between November 2018 and November 2019. AGYW were randomized to receive (1) group‐based community health club effective use counselling, (2) individualized effective use counselling or (3) community‐based PrEP dispensary. Task shifting of effective use counselling from nurses to trained lay counsellors was implemented in groups 1 and 2. Personnel costs were estimated from time‐and‐motion observations and staff interviews. Expenditure and ingredients‐based approaches were used to estimate costs for medical and non‐medical supplies. In total, 603 AGYW initiated PrEP and accrued a total of 1280 months on PrEP. Average cost per person‐month on PrEP with group‐based community health club, individualized effective use counselling and community‐based PrEP dispensary under the Department of Health scenario were similar and high (USD $55.32, $55.65 and $55.46, respectively) due to low PrEP client volume observed in the clinical trial. Increasing client volume (scaled Department of Health scenario) reduced cost per‐person month estimates to USD $15.48, $26.40 and $13.99, respectively. As designed, individualized effective use counselling increased the cost of standard‐of‐care PrEP delivery by 89%, group‐based community health effective use counselling increased the cost of standard‐of‐care PrEP delivery by 11%. These estimates can inform cost‐effectiveness and budget impact analysis for PrEP provision with effective use counselling services.
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DOI：
10.1097/qai.0000000000001575
发表时间：
2018-02-01
期刊：
Journal of acquired immune deficiency syndromes (1999)
影响因子：
--
作者：
Mugwanya KK;Baeten JM;Wyatt C;Mugo NR;Celum CL;Ronald A;Kiarie J;Katabira E;Heffron R;Partners PrEP Study and Partners Demonstration Project Teams
通讯作者：
Partners PrEP Study and Partners Demonstration Project Teams
影响因子：
6.4
作者：
Walensky，Rochelle P.;Jacobsen，Margo M.;Paltiel，A. David
通讯作者：
Paltiel，A. David
影响因子：
6.4
作者：
Hughes, James P.;Baeten, Jared M.;Celum, Connie
通讯作者：
Celum, Connie
影响因子：
6
作者：
Celum, Connie L.;Delany-Moretlwe, Sinead;Bekker, Linda-Gail
通讯作者：
Bekker, Linda-Gail
影响因子：
3.8
作者：
Fonner, Virginia A.;Dalglish, Sarah L.;Grant, Robert M.
通讯作者：
Grant, Robert M.