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
type: Article
item type: journalArticle
is part of: Frontiers in Public Health
publisher: Frontiers
authors: Person
  surname: d'Elbée
  given name: Marc
authors: Person
  surname: Traore
  given name: Métogara Mohamed
authors: Person
  surname: Badiane
  given name: Kéba
authors: Person
  surname: Vautier
  given name: Anthony
authors: Person
  surname: Simo Fotso
  given name: Arlette
authors: Person
  surname: Kabemba
  given name: Odé Kanku
authors: Person
  surname: Rouveau
  given name: Nicolas
authors: Person
  surname: Godfrey-Faussett
  given name: Peter
authors: Person
  surname: Maheu-Giroux
  given name: Mathieu
authors: Person
  surname: Boily
  given name: Marie-Claude
authors: Person
  surname: Medley
  given name: Graham Francis
authors: Person
  surname: Larmarange
  given name: Joseph
authors: Person
  surname: Terris-Prestholt
  given name: Fern
authors: Person
  surname: ATLAS Team
subject: Costs and Cost Analysis
subject: Côte d'Ivoire
subject: Female sex workers
subject: HIV self-testing
subject: Key populations
subject: Knowledge of HIV status
subject: Mali
subject: Men who have sex with men
subject: People who use injectable drugs
subject: Scale-up
subject: Senegal
subject: West Africa
subject: diagnosis
subject: screening
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 injectable drugs (PWuID) 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 an HIV 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). In this paper, we estimate the costs of implementing HIVST through twenty-three 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 PWuID. Average costs per HIVST kit distributed ranged $12-$15 (FSW), $14-$27 (MSM), and $15-$143 (PWuID), driven by personnel costs at various intervention levels (53%-78% of total costs), and HIVST kits costs (2%-15%). Estimated average costs at scale-up ranged $6-$13 (FSW), $6-$23 (MSM), and $14-$50 (PWuID), and were mainly explained by the spreading of IPO costs over higher HIVST distribution volumes. In all three 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). The analysis of costs at scale suggests that, in the transition to scale-up and further integration of the HIVST programme into CSO existing activities, this model can evolve…
date: 2021-05-24
citation key: delbeeCostsScaleUpCosts2021
date submitted: 2021-05-25 10:14:12
language: English
library catalog: Frontiers
rights: Licence Creative Commons Attribution - Partage dans les mêmes conditions 4.0 International (CC-BY-SA)

Frontiers in Public Health
type: Journal
volume: 9
alternative: Front. Public Health
identifier: DOI 10.3389/fpubh.2021.653612
identifier: ISSN 2296-2565